Karen Greiner, MD, MPH is a Complex Family Planning fellow at UC San Diego. She received a Master in Public Health focusing on Epidemiology as a medical student at Oregon Health & Science University. Her research has primarily focused on cost-effectiveness analyses and retrospective cohort studies covering a range of topics including hypertensive disorders of pregnancy and abortion.

During her fellowship she plans to expand her research portfolio by conducting a randomized controlled trial assessing the use of prophylactic tranexamic acid and bleeding outcomes at the time of dilation and evacuation (D&E). Anecdotally, clinicians are using TXA for the prevention and management of bleeding in abortion care although currently there are no published studies to support its use. This study will involve a randomized, placebo-controlled trial of pregnant patients aged 18 and older undergoing D&E for abortion or fetal demise at 18-24 weeks gestation. The primary aim is to determine whether prophylactic TXA has an effect on the need for additional interventions to control blood loss at the time of D&E. The study hypothesis is that prophylactic use of TXA at the time of D&E will result in fewer interventions to control excessive bleeding and a lower quantitative blood loss for the procedure. We anticipate the findings of this study will have a significant impact on national practice guidelines for the use of TXA at the time of D&E given no other study has been published assessing this intervention in abortion care.