Lagos — Doctors throughout Nigeria have joined their colleagues worldwide to research better ways of treating women who die from bleeding after childbirth.

A new trial (called the WOMAN Trial) has recently been launched. This trial will look at how effective a treatment called tranexamic acid is at reducing death and removal of the womb which can occur because of severe bleeding after childbirth.

There are effective treatments for preventing severe bleeding after childbirth. "Our first aim must be to ensure that pregnant women of Nigeria have access to these. However, even with these interventions, some women will develop severe bleeding after giving birth and we need to find better ways of treating them," a statement by the group said.

Tranexamic acid was recently tried in a global trial called CRASH-2. This trial involved over 20,000 people worldwide who had severe bleeding after injuries from car crashes and violence. Over 2,000 of these people were from Nigeria. The CRASH-2 trial found that tranexamic acid reduced the chances of death due to severe bleeding by about one sixth without increasing the risk of developing blood clots.

Deaths from complications of pregnancy and childbirth remain a leading public health problem in developing countries. Bleeding after childbirth is the most important cause of death in our women.

Severe bleeding after childbirth kills about 100,000 women each year. The vast majority of these deaths occur in Nigeria and other countries of Africa and Asia. The exciting results of the CRASH-2 trial raise the possibility that tranexamic acid might also save lives in women who develop severe bleeding after childbirth and the WOMAN trial aims to provide the answer.

Tranexamic acid is not a new drug and has been in use for about 50 years for many other bleeding medical conditions. The WOMAN trial will run for 5 years and aims to include 15,000 women who have been diagnosed with bleeding after childbirth. Nigeria needs to be the lead country for this research initiative because our women have the greatest burden from severe bleeding after childbirth.

The WOMAN trial has been approved by the National Health Research Ethics Committee (NHREC) and the Registration and Regulatory Directorate of NAFDAC. These agencies will monitor the implementation of the research in Nigeria.

Twenty eight hospitals including Federal Medical Centres, specialist and teaching hospitals and state maternity hospitals have approval already to participate in the WOMAN trial. However this trial is still open to doctors from all major hospitals who are interested.

The trial is coordinated by researchers at the London School of Hygiene and Tropical Medicine (University of London).