Groundbreaking Trial Shows Simple Intervention Can Dramatically Reduce Maternal Deaths

12 May 2023 • A recent trial conducted by the University of Birmingham has revealed a simple yet highly effective method for detecting and treating postpartum hemorrhage, a leading cause of maternal mortality worldwide. The study, conducted in 80 hospitals across Kenya, Nigeria, South Africa, and Tanzania, demonstrated that the use of a special blood collection drape combined with a rapid treatment ""bundle"" led to a 60% reduction in severe bleeding, the need for surgery, and maternal deaths.

Postpartum hemorrhage, which affects 14 million women annually and causes approximately 70,000 deaths, has long been a challenge in low and middle income countries. The trial addressed two major issues in managing the condition: inaccurate estimation of blood loss and delays in treatment initiation. By utilizing the blood collection drape, blood loss was objectively measured, allowing for timely interventions.

The intervention involved a coordinated approach, including uterine massage, administration of specific drugs, intravenous fluids, and the use of tranexamic acid. Rather than initiating treatments sequentially, as commonly practiced, all interventions were promptly administered together. The study, involving over 200,000 women, demonstrated a significant reduction in severe blood loss, laparotomy, and maternal deaths compared to the control group.

Lead researcher Arri Coomarasamy from the University of Birmingham described the results as ""remarkable"" and emphasized the inaccuracy of visual estimation in detecting postpartum hemorrhage. The trial confirmed the effectiveness of the treatment bundle devised by the World Health Organization.

To support the implementation of this approach, participating hospitals received additional resources, training, and data feedback. Funding from the Bill and Melinda Gates Foundation continues for the facilities involved. Health economic analyses are being conducted to help advocate for investment in this life-saving intervention.

Pascale Allotey from the World Health Organization stressed the importance of accessible and effective solutions to address postpartum hemorrhage. The trial's success offers hope for safer births and healthier futures for women worldwide.

Source: The BMJ | Read full story

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