Postpartum hemorrhage (PPH)– specified as the loss of more than 500 mL of blood within 24 hours after birth– is the leading reason for maternal death worldwide. It affects an estimated 14 million women each year and leads to around 70,000 deaths– primarily in low and middle-income nations– equivalent to 1 death every 6 minutes.
” Postpartum hemorrhage is frightening, not always predictable, however definitely treatable. Effective solutions to tackle postpartum bleeding require to be offered and available so that all females can experience a safe birth and a healthy future with their households.”
The study, which involved over 200 000 ladies in four countries, discovered that objectively determining blood loss utilizing an easy, affordable collection device called a drape and bundling together WHO-recommended treatments– instead of offering them sequentially– led to remarkable improvements in results for women. Severe bleeding– when a woman loses more than a liter of blood after birth– was minimized by 60%, and they were less likely to die.
There was also a significant reduction in the rate of blood transfusions for bleeding, which is of specific significance in low-income countries where blood is a pricey and scarce resource.
” This new method to dealing with postpartum hemorrhage might significantly improve ladiess chances of enduring childbirth globally, helping them get the treatment they need when they require it,” said Professor Arri Coomarasamy, who led the trial and is the Co-Director of the WHO Collaborating Centre on Global Womens Health at the University of Birmingham. “Time is of the essence when reacting to postpartum bleeding, so interventions that remove delays in diagnosis or treatment should be game-changers for maternal health.”
Currently, a significant difficulty in reacting to PPH is that it is typically spotted too late to respond successfully. Many providers use visual examination to assess bleeding, which tends to underestimate blood loss and can lead to lethal delays in treatment. When treatment is offered, this is generally done in a sequential manner with gaps between each intervention– costing more time if the first options are ineffective.
The suggested E-MOTIVE package includes early and accurate detection of PPH utilizing a blood-collection drape. This is complemented by an immediate treatment package where shown, consisting of uterine massage, medicines to contract the womb and stop the bleeding, intravenous fluid administration, an evaluation and, when required, escalation to innovative care. In the trial, the E-MOTIVE intervention was supported with an execution method consisting of specific training, PPH trolleys or bring cases, engagement of regional champs, audits and feedback. All parts of the E-MOTIVE intervention can be carried out by midwives.
This research study responds to among the top research top priorities recognized by more than 130 specialists from over 50 nations at the first Global Summit on PPH convened by WHO and HRP in March this year. The Summit marked the start of a collaborative global effort intending to substantially lower the problem of PPH and its consequences in low- and middle-income nations.
The main results of this research study were published on May 9 in the New England Journal of Medicine. The parallel-cluster randomized trial was a partnership between the WHO Collaborating Centre on Global Womens Health at the University of Birmingham, United Kingdom, and WHO, with the study conducted in 80 health centers throughout Kenya, Nigeria, South Africa and Tanzania.
Referral: “Randomized Trial of Early Detection and Treatment of Postpartum Hemorrhage” by Ioannis Gallos, D.M.S., M.D., Adam Devall, B.Med.Sci., Ph.D., James Martin, Ph.D., Lee Middleton, M.Sc., Leanne Beeson, B.Sc., Hadiza Galadanci, F.R.C.O.G., Fadhlun Alwy Al-beity, M.D., Ph.D., Zahida Qureshi, M.B., B.S., M.Med., G. Justus Hofmeyr, M.B., B.Ch., D.Sc., Neil Moran, B.M., B.Ch., Sue Fawcus, M.B., B.S., Lumaan Sheikh, F.C.P.S., M.R.C.O.G., George Gwako, M.B., Ch.B., Ph.D., Alfred Osoti, M.B., Ch.B., Ph.D., Ashraf Aswat, B.Sc., Kristie-Marie Mammoliti, M.Sc., Kulandaipalayam N. Sindhu, M.B., B.S., M.D., Marcelina Podesek, M.Sc., Isobelle Horne, B.A., Rebecca Timms, M.Res., Idnan Yunas, M.B., B.Chir., D.C.H., Jenipher Okore, B.Sc., Mandisa Singata-Madliki, Ph.D., Edna Arends, B.A., Aminu A. Wakili, M.B., B.S., Ard Mwampashi, B.A.P.S&& P.A., Sidrah Nausheen, M.B., B.S., Shah Muhammad, M.B., B.S., M.P.H., Pallavi Latthe, M.B., Ch.B., M.D., Cherrie Evans, Dr.P.H., C.N.M., Shahinoor Akter, Ph.D., Gillian Forbes, Ph.D., David Lissauer, M.B., Ch.B., Ph.D., Shireen Meher, M.B., B.S., M.D., Andrew Weeks, M.B., Ch.B., M.D., Andrew Shennan, M.B., B.S., M.D., Anne Ammerdorffer, Ph.D., Eleanor Williams, M.Sc., M.A., Tracy Roberts, Ph.D., Mariana Widmer, M.Sc., Olufemi T. Oladapo, M.D., M.P.H., Fabiana Lorencatto, Ph.D., Meghan A. Bohren, Ph.D., M.S.P.H., Suellen Miller, Ph.D., M.H.A., Fernando Althabe, M.D., Metin Gülmezoglu, M.D., Ph.D., Jeffrey M. Smith, M.D., M.P.H., Karla Hemming, Ph.D., and Arri Coomarasamy, M.B., Ch.B., M.D., 9 May 2023, New England Journal of Medicine.DOI: 10.1056/ NEJMoa2303966.
The E-MOTIVE task was supported by a grant from the Bill & & Melinda Gates Foundation.
A groundbreaking study by the World Health Organization (WHO) and the University of Birmingham presents E-MOTIVE, an unique service that might considerably lower deaths from childbirth-related bleeding, or postpartum hemorrhage (PPH). PPH, the leading cause of maternal mortality worldwide, affects 14 million females yearly and leads to approximately 70,000 deaths.
A trial of a set of interventions to manage postpartum hemorrhage, released in the New England Journal of Medicine, found a 60% decrease in heavy bleeding.
The E-MOTIVE solution, established by WHO and the University of Birmingham, could considerably lower childbirth-related bleeding and maternal death by utilizing a low-cost blood collection drape and bundling WHO-recommended treatments.
A brand-new option, called E-MOTIVE, could supply a major breakthrough in reducing deaths from childbirth-related bleeding, according to a landmark research study released on May 9 by researchers from the World Health Organization (WHO) and the University of Birmingham.
Reliable solutions to deal with postpartum bleeding need to be readily available and available so that all ladies can experience a safe birth and a healthy future with their households.”
Currently, a significant challenge in reacting to PPH is that it is frequently detected too late to respond successfully. Most providers use visual examination to evaluate bleeding, which tends to undervalue blood loss and can lead to lethal hold-ups in treatment. The suggested E-MOTIVE package consists of early and accurate detection of PPH utilizing a blood-collection drape. In the trial, the E-MOTIVE intervention was supported with an application method consisting of specific training, PPH trolleys or carry cases, engagement of regional champs, audits and feedback.
