POSTPARTUM haemorrhage (PPH) remains a leading cause of maternal mortality globally as it affects an estimated 14 million women each year, resulting in around 70,000 deaths – mostly in low and middle-income countries.
This figure is equivalent to one death every six minutes.
However, a study published on Tuesday, May 9, evaluated a series of interventions aimed at controlling postpartum hemorrhage and found a significant 60 per cent decrease in excessive bleeding.
The study which brought a new solution, known as E-MOTIVE, could provide a major solution in reducing deaths from childbirth-related bleeding, according to the study published by researchers from the World Health Organization (WHO) and the University of Birmingham.
According to WHO, Postpartum haemorrhage (PPH) is the loss of more than 500 mL of blood within 24 hours after birth.
The Director of Sexual and Reproductive Health and Research at WHO, Pascale Allotey, said the impact of Postpartum haemorrhage around the world is tragic.
“Postpartum haemorrhage is scary, not always predictable, but absolutely treatable. Nonetheless, its impacts around the world are tragic.
“No woman should fear for her life when giving birth. Effective solutions to tackle postpartum bleeding need to be available and accessible so that all women can experience a safe birth and a healthy future with their families.”
The study involved over 200,000 women in four countries, of which Nigeria is inclusive.
A total of 80 secondary-level hospitals across the four countries Kenya, Nigeria, South Africa, and Tanzania, in which the patients underwent vaginal delivery, were randomly assigned to the intervention group or the usual-care group.
The WHO researchers highlighted three key challenges that contributed to maternal complications across the world.
“The first challenge is that postpartum hemorrhage is often undetected or detected late; thus lifesaving treatment is not promptly initiated.
“The second challenge is delayed or inconsistent use of interventions for the management of postpartum hemorrhage.
“The third challenge is that despite the availability of clear recommendations regarding postpartum hemorrhage and their wide dissemination, uptake is poor at the point of care.”
The researchers found that objectively measuring blood loss using a simple, low-cost collection device called a ‘drape’ and bundling together WHO-recommended treatments – rather than offering them sequentially – resulted in dramatic improvements in outcomes for women.
The incidence of severe postpartum hemorrhage, defined as losing over a liter of blood after childbirth, decreased by 60 per cent, significantly reducing the risk of maternal mortality.
Additionally, there was a significant decrease in the frequency of blood transfusions required for managing bleeding, which is of particular importance in low-income countries where the availability and cost of blood are limited.
A researcher, Arri Coomarasamy, who led the trial said, “The new approach to treating postpartum haemorrhage could radically improve women’s chances of surviving childbirth globally, helping them get the treatment they need when they need it.
“Time is of the essence when responding to postpartum bleeding, so interventions that eliminate delays in diagnosis or treatment should be game-changers for maternal health.”
The recommended E-MOTIVE package includes early and accurate detection of PPH using a blood-collection drape and an immediate treatment bundle which includes uterine massage, medicines to contract the womb and stop the bleeding, intravenous fluid administration, an examination and, when needed, escalation to advanced care.
The research, according to WHO, responds to one of the top research priorities identified by more than 130 experts from over 50 countries at the first Global Summit on PPH convened by WHO and HRP in March 2023.
What does data say about Maternal Mortality in Nigeria?
According to a report by the World Health Organization, Nigeria’s estimated maternal mortality ratio was over 800 maternal deaths per 100,000 live births, with approximately 58,000 maternal deaths, in 2015.
The report stressed that a Nigerian woman has a one in 22 lifetime risk of dying during pregnancy, childbirth or postpartum/post-abortion; whereas in the most developed countries, the lifetime risk is one in 4,900.
In a recent 2023 news report, the United Nations Children’s Fund (UNICEF) said a new global maternal mortality report showed that 82,000 women in Nigeria die from pregnancy and childbirth-related complications every year.
UNICEF health chief in Nigeria Eduardo Celades disclosed the figure while presenting a report titled, ‘Trends in maternal mortality 2000 to 2020,’ during a media dialogue on COVID-19 and routine immunisation organised by the UNICEF Nigeria Office.
He said the figure translated to 225 deaths from maternal mortality every day, noting that the number of women dying from pregnancy-related causes in the country was very high.
Usman Mustapha is a solution journalist with International Centre for Investigative Reporting. You can easily reach him via: [email protected]. He tweets @UsmanMustapha_M