Intervention comprising early detection and use of bundled treatment leads to reduction in composite primary outcome
By Elana Gotkine HealthDay Reporter
FRIDAY, May 12, 2023 (HealthDay News) — For patients having a vaginal delivery, early detection of postpartum hemorrhage and use of bundled treatment leads to a reduction in a composite of severe postpartum hemorrhage, laparotomy for bleeding, or death from bleeding, according to a study published online May 9 in the New England Journal of Medicine. The research was published to coincide with the International Maternal Newborn Health Conference, held from May 8 to 11 in Cape Town, South Africa.
Ioannis Gallos, M.D., from the World Health Organization in Geneva, Switzerland, and colleagues conducted an international, cluster-randomized trial to assess a multicomponent clinical intervention, including a calibrated blood-collection drape for early detection of postpartum hemorrhage and a bundle of first-response treatments supported by an implementation strategy, in patients undergoing vaginal delivery. Eighty secondary-level hospitals across Kenya, Nigeria, South Africa, and Tanzania, with 210,132 patients undergoing vaginal delivery, were randomly assigned to intervention or usual care.
The researchers found that a primary outcome event (composite of severe postpartum hemorrhage, laparotomy for bleeding, or maternal death from bleeding) occurred in 1.6 and 4.3 percent of patients in the intervention and usual care groups, respectively (risk ratio, 0.40). Postpartum hemorrhage was detected in 93.1 and 51.1 percent of patients in the intervention and usual care groups, respectively (rate ratio, 1.58); the treatment bundle was used in 91.2 and 19.4 percent, respectively (rate ratio, 4.94).
“The E-MOTIVE intervention resulted in a 60 percent lower risk of the primary outcome,” the authors write.
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