Saving moms' lives during childbirth becomes even easier

After a woman gives birth to her baby, the work is not over. She must also be born the placenta. And that can be very risky.

The placenta attaches to the uterus through a series of blood vessels that range from the mother to the placenta. After delivery, the placenta tears off the uterus, leaving these vessels open and exposed.

"It's just a part of the bleeding," says Dr. Jeffrey Smith, a gynecologist from the nonprofit Jhpiego in Baltimore. "The uterus has wide and widely open vessels that have shed blood for nine months and now, all of a sudden, these vessels have to close."

In many cases, the uterus stops this bleeding on his body. own. He contracts and literally squeezes the closed vessels.

But in about one in six women, the uterus can not contract fast enough. Without help, the woman bleeds to death.

Here in the United States, doctors give women the hormone oxytocin to help the uterus to tighten and stop bleeding, often intravenously but also by injection

An option in many places – not because it's not available but because it has to stay cold. It degrades when it is stored above 86 degrees Fahrenheit

"It's a huge problem," Smith says. "In many clinics around the world, oxytocin will be ready for use, but health workers do not know which vials have lost their effectiveness."

The World Health Organization now says that it has found a way around this sensitivity to temperature – and the solution could save tens of thousands of lives each year.

A few years ago, Ferring Pharmaceuticals chemists developed a thermostable version of an oxytocin-like molecule that retains its potency even after sitting at 86 degrees Fahrenheit for three years, or 104 degrees Fahrenheit for six months.

WHO then conducted a mbadive trial around the world to test the new drug – called thermostable carbetocin. And overall, it works as well as oxytocin, reports WHO Wednesday in The New England Journal of Medicine . And it is also safe.

The study included nearly 30,000 women in ten countries. About half of the women received a dose of oxytocin immediately after badl delivery. The other half received a shot of thermostable carbetocin.

The results: Blood loss was similar in both groups. About 14.5% of women in both groups lost at least half a liter of blood after delivery. And the percentage of women who lost more than one liter of blood was not statistically different for both groups: 1.45% for women who received oxytocin and 1.51% for those receiving carbetocin.

"We are very excited about this drug," says midwife Anatole Manzi, who leads quality and patient safety for the nonprofit Partners In Health. "We want to start use it right away. "

" I have seen so many cases in which my colleagues were using oxytocin, and the woman continues to bleed excessively because the drug has lost its potency "To see a woman die of bleeding, she never leaves your mind."

But, Manzi says, for the drug to be effective, it must be affordable.

At present, we do not know how much heat … "It's too early to comment on prices in specific countries," Klaus Dugi, of Ferring Pharmeceuticals, told NPR in an email. collaborates with WHO and other companies "with the aim of making carbetocin rostable available at an affordable and sustainable price, "he writes.

Copyright NPR 2018.