Yoshihide Inayama, Toshi A. Furukawa, Yoshitsugu Chigusa, Masaki Mandai
In their systematic review and Bayesian network meta-analysis on postpartum haemorrhage prophylaxis in caesarean deliveries (August, 2025), Amaral and colleagues1 reported risk ratios (95% credible intervals) of 0·44 (0·33–0·58) for oxytocin plus tranexamic acid versus oxytocin alone and 0·54 (0·37–0·74) for carbetocin versus oxytocin alone. Although informative, the systematic review raises several methodological concerns.