A low-cost and widely available drug could save the lives of 1 in 3 mothers who would otherwise bleed to death after childbirth, according to a new study.
Severe bleeding, known as postpartum hemorrhage, or PPH, is the leading cause of maternal death worldwide, killing more than 100,000 women every year. Even for mothers who survive, it is a painful and traumatic experience. The world's poorest countries, especially in Africa and India, are the worst hit.
Drug from 1960s
But there is new hope. In the 1960s, Japanese researchers developed a drug called tranexamic acid, which works by stopping blood clots from breaking down. But they could not persuade doctors to try the drug for treating PPH.
The London School of Hygiene and Tropical Medicine has done just that, in a trial involving 20,000 women in 21 countries, mainly in Africa and Asia. The results show tranexamic acid reduces the risk of bleeding to death by almost a third, with no side effects for either mothers or babies.
Dr. Nike Bello, a consultant obstetrician and gynecologist in Nigeria, said that "if a drug can prevent hysterectomies, a drug can prevent death, a drug can minimize the amount of blood we need, then that is a good thing, all over the world."
But there are challenges to getting the drug where it is needed. First, the doctors must know about its effectiveness, said professor Ian Roberts of the London tropical medicine school, who led the latest research.
"We want everyone to hear about the results," he said. "But then there are the nitty-gritty issues. Is the treatment available in the hospital? Do doctors and midwives know how to use it? It is heat stable, so it does not have to be kept in the fridge. It is relatively inexpensive — it is about a dollar. And no child should grow up without a mother for lack of a treatment that costs a dollar."
In the trial, tranexamic acid was given via a drip. Researchers say the next step is to find an easier way to administer the drug so it can be used in clinics and rural settings across the world.