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Postpartum haemorrhage (HPP) – or excessive bleeding after childbirth – claims the lives of tens of thousands of women a year and is usually treated with a drug called oxytocin.
But new research has found a new version of the drug carbetocin, which does not require refrigeration, is as effective as oxytocin in the prevention of this form of hemorrhage. Oxytocin, should be stored at cool temperatures – between 2 and 8 degrees Celsius (35.6-46.4 degrees Fahrenheit). It is already known that carbetocin is safe and effective in preventing bleeding, but this reformulation used in the study offers an alternative without the challenge of transport and cold storage.
" For many years we have been looking for," said Ms. Mariana Widmer, Technical Manager in the Department of Reproductive Health and Research of WHO, lead author of the study.
Carbetocin is very similar to oxytocin, but instead of breaking down at low temperature, it has been shown that carbetocin remains stable at 30 degrees Celsius (86 degrees Fahrenheit) and at 75% relative humidity up to 36 months. (Oxytocin is more sensitive to moisture than to heat.)
"Giving drugs to contract the uterus after childbirth is the cornerstone of efforts to prevent hemorrhage ost-partum, "said Ian Roberts, professor of epidemiology and public health. of Hygiene and Tropical Medicine, who did not participate in the study. "Oxytocin is the medicine currently recommended, but it is heat sensitive and is losing power in hot climates – the kinds of places where many mothers die."
That is why the researchers compared the efficacy of carbetocin and oxytocin and demonstrated that carbetocin can withstand high temperatures and that it is as safe and effective as oxytocin to prevent HPP, defined as a blood loss of at least 500 ml after badl delivery.
For this they followed 29,645 women from 23 different sites in 10 different countries, including Argentina, India, Kenya, Nigeria, Singapore, South Africa, Thailand, Uganda and United Kingdom, between 2015 and 2018.
"The development of a drug to prevent Postpartum haemorrhage that continues to remain effective in hot, humid conditions is very good news for the millions of women who give birth in parts of the world without access to reliable refrigeration, "said Dr. Metin Gülmezoglu , coordinator of maternal and perinatal health and prevention of unsafe abortion at the WHO.
"This is a truly encouraging new development that can revolutionize our ability to keep mothers and babies alive," said Dr Tedros Adhanom Ghebreyesus, WHO Director-General in a statement.
But there are some caveats, the most obvious, about the feasibility of deploying carbetocin. "Thermostable carbetocin is much more expensive than oxytocin, and the pharmaceutical company that has an agreement with the WHO to make it available at a reasonable price in poor countries, but the devil is in the detail Roberts said.
"How much will it cost, which countries will receive it, for how long, will it reduce the availability of cheaper oxytocin?" And what about poor mothers in rich countries? 19659023]
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