Pregnant women in India receive treatment prior to childbirth


By Drew McLachlan

A widely available and affordable drug could save the lives of one in three mothers who would otherwise bleed to death following childbirth, according to new research.

Post-partum haemorrhage remains the leading cause of maternal death across the world and is especially prevalent in much of Asia and Africa. Each year, more than 100,000 women globally die from the condition.

In India alone, 174 of every 100,000 live childbirths results in maternal mortality, with post-partum haemorrhage being the single leading cause, according to the World Health Organisation.

But a recent global trial, which took place in 193 hospitals mainly in Asia and Africa, found that administering tranexamic acid (TXA) can be incredibly effective in preventing post-partum haemorrhage, reducing deaths caused by bleeding by 31 per cent if administered within three hours after entering labour.

Researchers also found that TXA reduced the need for urgent surgery to control bleeding by 36 per cent.

Ian Roberts, who led the trial, explained that TXA is currently used by surgeons to reduce bleeding, and is already widely available and affordable across the globe.

Although the trials took place within hospitals, many women in the developing world still give birth at home, posing a challenge for administering TXA, which must be injected into a vein.

Professor Ian Roberts
Ian Roberts, a professor at the London School of Hygiene and Tropical Medicine, led the trial.

“TXA is widely available everywhere, but it is difficult to administer it if you’re delivering at home,” Roberts said. “Many women deliver at home or in rural health clinics where people may not be able to give an intravenous injection, so we’re looking into ways we can deliver the same treatment without an intravenous injections. Perhaps an injection into the muscle, which is easier to do, or a tablet under the tongue.”

There are several causes that can lead to fatal post-partum haemorrhage, Roberts explained. The uterus normally contracts down after childbirth in order to prevent bleeding, though sometimes this fails to happen, often due to the exhaustion caused by the childbirth process.

The placenta can also fail to detach properly, worsening bleeding. Trauma can also play a factor, as tears are sometimes made to the vagina and cervix during childbirth and can lead to severe bleeding.

“it has the potential to help save the lives of many of our women.”

Dr Rishma Pai, president of the Federation of Obstetric and Gynaecological Societies of India, said: “India suffers a huge burden of young mothers dying from heavy bleeding after childbirth. This leaves thousands of our children to grow up without a mother. The results of this important study are very encouraging. Tranexamic acid is a simple treatment that I hope will be used by doctors across the country, as it has the potential to help save the lives of many of our women.”

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