Pregnant women might be at less risk of suffering hemorrhages following childbirth thanks to an inexpensive generic drug that saves the lives of car crash victims and wounded soldiers.
An estimated 100,000 women in poor and middle-income countries die from postpartum hemorrhage, meaning that they bleed uncontrollably after childbirth. Postpartum hemorrhage can result in the need for emergency hysterectomies when hospitals are low on blood supply and cannot provide transfusions.
A major six-year trial known as Woman—abbreviated from World Maternal Antifibrinolytic—included over 20,000 women in 21 countries, and revealed that tranexamic acid, an obscure blood-clotting drug invented in the 1950s, reduced maternal bleeding deaths by a third if it was administered within three hours. Tranexamic acid does not require refrigeration, and costs less than $2 a dose.
Doctors at the London School of Hygiene and Tropical Medicine led the trial which was financed by the Wellcome Trust, Pfizer, Britain’s health department and the Bill and Melinda Gates Foundation. On Wednesday, The Lancet published the results of the trial.
“Tranexamic acid can save women’s lives and ensure more children grow up with a mother,” said Haleema Shakur, one of the study’s lead authors.
According to the World Health Organization, the current recommended treatment for postpartum hemorrhage involves massaging the uterus and injecting drugs that will shrink the uterus, such as oxytocin.
Another lead author of the study, Dr. Ian Roberts, asserts that tranexamic acid acts differently—by allowing blood to clot more quickly—and should be administered simultaneously with the usual practices.
“Women die very quickly from this, especially in Africa, because they are so profoundly anemic,” Dr. Roberts said. “Half the women giving birth there start off with roughly half the red blood cells they should have. If you or I had hemoglobin counts that low, we’d be breathless.”
“Doctors are forced to throw in everything they’ve got, because they know the woman can be dead in an hour,” he said.
Dr. Roberts noted that emergency hysterectomies save some lives, but women who undergo the procedures are unable to produce another child. He contends that it is “logical to infer” that the need for such surgeries would also be reduced if tranexamic acid became widely available in delivery rooms.
The New York Times reported that “Dr. Jerker Liljestrand, a maternal health specialist at the Gates Foundation, said the organization will work with the WHO and local governments to make sure tranexamic acid becomes part of the recommended treatment for post-partum bleeding.”
H/T: The New York Times
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