Drug May Reduce Deaths Due to Childbirth Bleeding

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Bleeding and hemorrhaging during childbirth is a major reason why women die during labor in the developing world. A new study shows that an inexpensive drug can reduce bleeding by 80 percent in the most serious cases. If women in developing countries had access to it, it could save 150,000 lives a year.

STEVE INSKEEP, host:

A drug originally meant to treat ulcers could also help women who just gave birth. A study in the British medical journal, The Lancet, says the drug is effective in preventing postpartum bleeding for women.

The drug could save thousands of lives in poor countries, as NPR's Brenda Wilson reports.

BRENDA WILSON: Despite advances in medical science, thousands of women in developing countries still bleed to death each year after giving birth, usually at home, on a floor, far away from any medical facility.

Dr. Richard Derman, professor of obstetrics and gynecology at the University of Kansas, says women in developing countries are often anemic and unable to survive heavy losses of blood.

Dr. RICHARD DERMAN (Professor of Obstetrics and Gynecology at the University of Kansas): When an auxiliary nurse midwife or another healthcare provider in the rural areas discovers that a woman is bleeding too much, by the time they transfer the patient, because of the underlying anemia, often, the patient unfortunately goes into irreversible shock and dies.

WILSON: The bleeding may be caused by tears, but mainly because the uterus fails to contract after the baby is delivered, a condition that is relatively easy to treat in the U.S., but leads to a third of the half-million women who die in labor in poor countries.

Researchers at the National Institutes of Health's Global Network for Women and Children's Health wondered if Misoprostol, which is used to prevent bleeding from gastric ulcers, might not reduce postpartum bleeding. Three years ago, midwives in rural India were trained to give pregnant women three tablets right after the baby was born.

Dr. DERMAN: Being able to go ahead and use this medication right after the baby is born and the cutting and clamping of the cord, is really a very significant thing. And we were able to see a reduction of 47 percent, almost 50 percent, among those women who utilized study drug as compared to an identical placebo. And women who bled the most actually had an 80 percent reduction in overall blood loss.

Dr. ABDELHADI ELTAHIR (Senior Medical Associate, Gender Health): I find that the results are extremely exciting.

WILSON: Dr. Abdelhadi Eltahir is the senior medical associate within Gender Health. It's part of a group working on technical protocols for women in labor in the developing world, where women often give birth alone or with unskilled birth attendants.

Dr. ELTAHIR: In most of sub-Saharan Africa, their main problem is lack of skilled attendants. So unskilled attendants or unattended births, that is a major problem, and it is causing a lot of complications. But in terms of using this new drug, I think even if it is used by unskilled attendants I would see great benefits in using it than in not using it, because it is a life-saving treatment that's not really found in unreachable areas.

WILSON: A study in Indonesia found that if instructions on the drug's use are clear, it can be safely used even where there are no community health workers available. India's ministry of health and three countries in Africa have already approved the drug for use by trained healthcare providers. The hope now is that this study will persuade the World's Health Organization to recommend Misoprostol as an alternative to medications which can now only be given at a hospital or clinic.

The three-tablet treatment with Misoprostol ranges from 50 cents to $1.

Brenda Wilson, NPR News.

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