Topline
Researchers on Tuesday announced a lifesaving method of treating childbirth-related bleeding, hailing it as a major breakthrough in tackling the leading cause of maternal deaths as the World Health Organization warns progress tackling deaths among mothers and newborns has “flatlined” in recent years due to persistent failure to invest in healthcare systems.
A new approach to treating postpartum bleeding could save lives, the WHO said.
Key Facts
Postpartum hemorrhage—defined as losing more than 500ml of blood within 24 hours after birth— is the leading cause of maternal mortality worldwide, the WHO said, affecting an estimated 14 million women each year.
Pascale Allotey, Director of Sexual and Reproductive Health and Research at WHO, said the condition, which leads to around 70,000 deaths a year, is “scary, not always predictable, but absolutely treatable.”
Timing, however, is crucial and the researchers said a major challenge is that postpartum bleeding is often detected too late to respond effectively, compounded by the fact that many healthcare providers assess blood loss using a visual inspection (which typically underestimates bleeding) and provide treatment sequentially with gaps between each effort, costing even more time if ineffective.
Objectively measuring blood loss with a “drape,” a low-cost collection device and bundling together recommended treatments for postpartum bleeding like uterine massage, medicines that contract the womb to stem bleeding and intravenous fluids resulted in “dramatic” improvements, the WHO said.
The WHO said the protocol, dubbed E-MOTIVE and backed by a study that involved over 200,000 women in four countries, cut severe bleeding—losing more than 1,000ml of blood after birth—by 60% and marks a “major breakthrough” in preventing maternal deaths.
E-MOTIVE also dramatically reduced the rate of blood transfusions needed for bleeding, the researchers found, a particularly important finding for less wealthy countries where blood is scarce and expensive.
Crucial Quote
“This new approach to treating postpartum hemorrhage could radically improve women’s chances of surviving childbirth globally, helping them get the treatment they need when they need it,” said Arri Coomarasamy, who led the trial and is a professor at the University of Birmingham in the U.K., co-directing the WHO collaborating center on global women’s health. “Time is of the essence when responding to postpartum bleeding, so interventions that eliminate delays in diagnosis or treatment should be gamechangers for maternal health.”
News Peg
The study, published in the New England Journal of Medicine, comes as the United Nations warns that progress tackling deaths among pregnant women, mothers and newborn babies has “flatlined” for the last eight years. The report, released by the WHO on Tuesday, said rising poverty, the Covid-19 pandemic and numerous humanitarian crises have stretched already struggling healthcare systems, with funding shortfalls and chronic underinvestment in primary and maternal care threatening to “devastate survival prospects.” As with postpartum bleeding, less affluent countries bear the brunt of this burden and the WHO said less than a third of countries report having sufficient newborn care units to treat small and sick babies despite prematurity being the leading cause of deaths under the age of five globally.
Big Number
4.5 million. That’s how many women and babies die during pregnancy, childbirth or in the first weeks after birth, according to the WHO report. This is equivalent to 1 death every 7 seconds, the WHO said, which noted many causes of death are preventable or treatable if proper care were available. This figure includes around 290,000 maternal deaths annually, 1.9 million stillbirths—babies dying after 28 weeks of pregnancy—and 2.3 million newborn deaths within the first month of life.
Further Reading
Maternal Deaths Spiked In 2021—Particularly Among Black Women—As U.S. Maintains Deadly Reputation For Pregnancy And Childbirth (Forbes)
Global push to tackle maternal and newborn deaths has stalled, WHO report finds (Reuters)
Source: https://www.forbes.com/sites/roberthart/2023/05/09/lifesaving-treatment-found-for-postpartum-bleeding-the-leading-cause-of-maternal-deaths/