A large-scale, randomized trial by the World Health Organization has found a new option to prevent excessive blood loss after childbirth. Currently, the WHO recommends oxytocin as a first-line treatment for excessive postpartum hemorrhage, but Oxytocin has the drawback of requiring refrigeration at 2 to 8 degrees Celsius during storage and transport.
The new medication, a heat-stable formulation of the existing drug carbetocin, can be stored for at least three years at 30 degrees Celsius and 75% humidity. In the study, which involved nearly 30,000 women who gave birth vaginally across 10 countries and was published in the New England Journal of Medicine, carbetocin proved just as effective as oxytocin in reducing postpartum bleeding. Experts say it is likely to prove more effective, as the study ensured both medications were transported and stored per oxytocin standards; in real life conditions, oxytocin is often transported and stored improperly, making it less effective in treating postpartum women.
“This is a truly encouraging new development that can revolutionize our ability to keep mothers and babies alive,” says Dr Tedros Adhanom Ghebreyesus, Director-General of WHO.
India’s maternal mortality rate has dropped considerably in recent years — by 22% over the last five years, to 130 deaths in 100,000 live births, to be precise. A Sample Registration System bulletin in June noted that 30 more pregnant women each day were surviving in 2016, than in 2013. A heartening improvement, but still a far cry from the 26.4 deaths in 100,000 — the highest maternal mortality rate in the developed world (US). While the reasons for the still-high maternal mortality ratio are complex, one factor may well be the country’s underdeveloped pharmaceutical cold chain sector — a documented cause of medical spoilage. Oxytocin is on India’s 2015 National List of Essential Medicines, but whether it is being transported and stored at optimal temperatures — and thus being administered with maximum effect — is unknown.
The next steps for carbetocin involve regulatory review and approval by countries.
