A ground-breaking study published by researchers from the World Health Organisation (WHO) and the University of Birmingham reveals that a new solution, known as E-MOTIVE, could be a significant breakthrough in reducing deaths caused by childbirth-related bleeding. The study was conducted in 80 hospitals across Kenya, Nigeria, South Africa, and Tanzania, funded by the Bill & Melinda Gates Foundation.
This innovative approach has the potential to address Postpartum Haemorrhage (PPH), which is the primary cause of maternal mortality worldwide. Each year, approximately 14million women are affected by PPH, resulting in around 70,000 deaths, with a death occurring every six minutes, predominantly in low and middle-income countries.
The study, which involved over 200,000 women, demonstrated that implementing E-MOTIVE led to remarkable improvements in outcomes. This involved measuring blood loss using a cost-effective collection device called a 'drape' and combining WHO-recommended treatments. As a result, severe bleeding, defined as losing more than one litre of blood after birth, was reduced by 60 per cent, significantly decreasing the risk of maternal mortality.
During the intervention, there was a significant decrease in the need for blood transfusions, which is particularly crucial in low-income countries where blood is scarce and expensive. Currently, one major challenge in addressing PPH is the late detection, often resulting in delayed and ineffective treatment.
Professor Arri Coomarasamy from our Women’s Hospital, who led the trial and is the Co-Director of the WHO Collaborating Centre on Global Women's Health at the University of Birmingham, highlighted the potential of this new approach to transform maternal health globally by enhancing women's chances of surviving childbirth. The elimination of delays in diagnosis and treatment is crucial in responding to postpartum bleeding, making interventions like E-MOTIVE significant game-changers.
Professor Arri Coomarasamy followed: “The trial is already seeing a significant shift in the way that we provide solutions for postpartum haemorrhage during birth and will go on to save lives of women, particularly in low- and middle-income countries. It’s important to us that we spot the challenges and identify simple cost-effective solutions to ensure women are safe during birth.”
Our Women’s Hospital Research and Development Director, Professor Shakila Thangaratinam said: “The intervention provides a simple and effective solution to reduce maternal mortality caused by postpartum haemorrhage.”
The recommended E-MOTIVE package includes early and accurate detection of PPH using a blood-collection drape. It is accompanied by an immediate treatment bundle, which involves uterine massage, medications to contract the womb and stop bleeding, intravenous fluid administration, an examination, and, if necessary, escalated care. Midwives are capable of performing all components of the E-MOTIVE intervention.
This research addresses one of the top research priorities identified at the first Global Summit on PPH, convened by WHO and HRP, which involved more than 130 experts from over 50 countries earlier this year. The Summit marked the initiation of a collaborative global initiative aimed at significantly reducing the burden of PPH and its consequences in low and middle income countries.