Drug effective against leading cause of maternal death, study finds

Dhaka, Bangladesh - A mom and her new born baby at the Maternal and Child Health Training Institute in 2010. South and South-West Asia has one third of the world’s maternal deaths. (Kibae Park/Sipa Press, Flickr)

An inexpensive and widely available drug could save the lives of thousands of women who die each year from severe bleeding after childbirth – the leading cause of maternal death worldwide, according to new study.

The drug, called tranexamic acid, works by stopping blood clots from breaking down. The global trial of 20,000 women found that death was reduced by 31 percent if the treatment was given within three hours after the start of bleeding.

“This is the first time we’ve shown that tranexamic acid can save the lives of mothers from postpartum hemorrhage,” Haleema Shakur, project director on the trial and associate professor of clinical trials at the London School of Hygiene & Tropical Medicine, said in an interview with Humanosphere.

Current World Health Organization guidelines recommend that tranexamic acid be used after the first and second line of treatments fail. But as Shakur explained, previous research had primarily only focused on treating the cause of the bleeding.

“Instead … it really is important that we focus also on what’s happening in the blood of the woman when she’s bleeding. Because if we can form a stable clot, then we can buy time to do other things and save women’s lives,” Shakur said.

Severe bleeding after childbirth (known as postpartum hemorrhage) is the leading cause of maternal death worldwide, taking the lives of more than 100,000 women each year. Low- and middle-income countries bear 99 percent of the burden, particularly sub-Saharan Africa, South Asia and in fragile and humanitarian settings.

The WHO reported that those at most risk of death during pregnancy or childbirth are adolescent girls under 15 years old and women in developing countries, who have many more pregnancies on average than women in developed countries.

Still, global health agency officials say most maternal deaths are preventable. Women in developing countries are not getting the care they need; In 2015, births in the world’s richest 20 percent of households were more than twice as likely to be attended by skilled health personnel as those in the poorest 20 percent of households, according to WHO statistics.

Experts also stress the need to prevent unwanted and teenage pregnancies through wider access to contraception, safe abortion services and quality post-abortion care.

While the new findings could lead to significant reduction in maternal mortality rates, Shakur said the results are useless if not made affordable. She said the price varies enormously by country; in the U.K., one dose of tranexamic acid might cost about $3.85. In a country like Pakistan, where patients are typically given generic drugs, the same dose would cost less than a dollar.

“In a poor country, 50 pence or a dollar is still a lot of money,” Shakur said. “But if it means saving the life of a mother, or preventing surgery or the use of blood, for example, then it’s very cost-effective.”

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Lisa Nikolau

Lisa Nikolau is a Madrid-based reporter for Humanosphere, covering gender equality, indigenous rights and poverty in Latin America and worldwide. Find her on Twitter at @lisanikolau, email lisa.nikolau@humanosphere.org or see her latest work at www.lisanikolau.com