Every year more than 300,000 women die in pregnancy or childbirth. A third of the deaths are from excessive bleeding after delivery. Research at the University of Birmingham is designed to address this pressing global challenge.

Uterotonic drugs

Drugs to contract the uterus, called uterotonic drugs, can prevent postpartum haemorrhage. Different drugs such as oxytocin, misoprostol and carbetocin have different effectiveness and side-effects. The question is: which is best? We are synthesising all the available evidence from hundreds of randomised clinical trials to compare the different uterotonic drugs against one another, even though individual pairs of drugs may not have been compared directly. We are working with the World Health Organisation to inform international clinical recommendations.

Clinical trial

Most uterotonic drugs are limited by the requirement for refrigeration, but it is often difficult to maintain a cold chain in low resource countries. Therefore we are participating in a randomised clinical trial of over 30,000 women in 10 countries, comparing a currently recommended drug (oxytocin) to a new formulation of carbetocin, that is stable at room temperatures.

Research lead Professor Arri Coomarasamy says: ‘Through our research, we will identify the safest and most effective uterotonic drug to prevent and treat excessive bleeding after childbirth.’