Postpartum hemorrhage (PPH), excessive bleeding that occurs shortly after birth, is the leading cause of maternal mortality in low-income nations. It can affect new mothers anytime and anywhere, though, and according to the World Health Organization (WHO), it’s the primary cause of around a quarter of all maternal deaths globally.
Clearly, it’s a serious problem. A treatment is available, but because of how it works, it’s not available to those living in remote locations, particularly in warm, arid parts of the world. A new study, spearheaded by Swiss-based Ferring Pharmaceuticals, is now presenting a new way to treat PPH that could close this dangerous gap.
Writing in the New England Journal of Medicine, the team explains that data from nearly 30,000 women indicates that carbetocin, a heat-stable compound, is just as effective at stemming PPH as oxytocin, the current standard of care. If corroborated, this research – conducted in conjunction with the WHO – could end up saving countless lives in countries with inadequate health infrastructures.
Primary PPH is defined as a loss of more than 500 milliliters of blood from the female genital tract 24 hours after birth. (Secondary occurs from those 24 hours up to six weeks post-birth.) It’s not always fatal, but it can be – multiple organ failure is a possibility, for example, if it’s not stopped.
The causes of PPH are varied, but include a failure of the womb to properly contract after birth, the presence of part of the placenta in the womb, or an infection in the womb’s lining. This in itself is an ongoing field of research.
In order to help prevent PPH, women are offered an injection of the hormone oxytocin as birth is taking place. This helps to stimulate contractions, and helps push the baby out safely.
The problem with oxytocin is that it must be stored and transported in a narrow temperature range: 2-8°C (35.6-46.4°F). This is fine in wealthy nations with good health infrastructures.
However, in many less developed nations, transporting oxytocin over distances to those that need it, or even just keeping it at room temperature, sees it degrade and become less effective. Around 70,000 lives are lost as a result of this every single year, so how can this be prevented?