Life-Saving Solution Drastically Reduces Severe Postpartum Bleeding

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A new solution, known as E-MOTIVE, could provide a breakthrough in reducing deaths from childbirth-related bleeding, according to a reference study published today by researchers from the World Health Organization (WHO) and the University of Birmingham.

Postpartum hemorrhage (PPH), defined as the loss of more than 500 mL of blood within 24 hours of birth, is the leading cause of maternal mortality worldwide. It affects approximately 14 million women each year and causes around 70,000 deaths, mainly in low- and middle-income countries, which is equivalent to 1 death every 6 minutes.

“Postpartum hemorrhage is terrifying, not always predictable, but absolutely treatable. Yet its impacts around the world are tragic,” said Dr. Pascale Allotey, WHO Director of Sexual and Reproductive Health and Research and head of the United Nations Special Program for Research, Development and Research Training in Human Reproduction. United (HRP). “No woman should fear for her life when giving birth. Effective solutions to address postpartum bleeding must be available and accessible so that all women can experience a safe birth and a healthy future with their families.”

The study, which involved more than 200,000 women in four countries, found that objective measurement of blood loss using a simple, low-cost collection device called a “drape” and collecting WHO recommended treatments, rather than being offered sequentially, resulted in dramatic improvements in outcomes for women. Severe bleeding, when a woman loses more than a liter of blood after childbirth, was reduced by 60% and she was less likely to lose her life.

There was also a substantial reduction in the rate of blood transfusions for bleeding, which is of particular importance in low-income countries where blood is a scarce and expensive resource.

Currently, a major challenge in responding to PPH is that it is often detected too late to respond effectively. Most providers use visual inspection to assess for bleeding, which tends to underestimate blood loss and can lead to life-threatening treatment delays. When treatment is provided, it is usually done sequentially with intervals between each intervention, which costs more time if the first options are not effective.

“This new approach to treating postpartum haemorrhage could radically improve the chances of women surviving childbirth around the world, helping them get the treatment they need when they need it,” said Professor Arri Coomarasamy, who led the trial. and is co-director of the WHO Collaborating Center. Center on Global Women’s Health at the University of Birmingham. “Time is of the essence when responding to postpartum bleeding, so interventions that eliminate delays in diagnosis or treatment should be a game changer for maternal health.”

The recommended E-MOTIVE package includes early and accurate detection of PPH using a blood collection drape. This is complemented by an immediate treatment package where indicated, including uterine massage, medication to contract the uterus and stop bleeding, intravenous fluids, an examination and, where necessary, escalation to advanced care. In the trial, the E-MOTIVE intervention was supported with an implementation strategy that consisted of targeted training, PPH carts or briefcases, involvement of local champions, audits, and feedback. All components of the E-MOTIVE intervention can be performed by midwives.

This research responds to one of the main research priorities identified by more than 130 experts from more than 50 countries at the first World Summit on PPH convened by the WHO and HRP in March this year. The Summit marked the start of a collaborative global initiative that aims to substantially reduce the burden of PPH and its consequences in low- and middle-income countries.

About the study

The main results of this study are published today in the New England Journal of Medicine. The parallel group randomized trial was a partnership between the WHO Collaborating Center for Global Women’s Health at the University of Birmingham, UK, and WHO, with the study conducted in 80 hospitals in Kenya, Nigeria, South Africa and Tanzania.

The E-MOTIVE project was supported by a grant from the Bill & Melinda Gates Foundation.

Media Contacts

Whom
Laura Keenan, [email protected]+4179 500 65 64 and [email protected]

the university of birmingham

Tim Mayo, [email protected]+44 (0)7920 405040