Every day around 800 women and over 3,500 babies die as a result of childbirth and complications of pregnancy. At the University of Birmingham, Professor Arri Coomarasamy and his team are investigating ways to stop mothers dying from bleeding and sepsis, two of the most common causes of mothers dying.
In the modern world, pregnancy and childbirth are considered safe and simple events that occur thousands of times every day. However, a straightforward childbirth can sometimes quickly turn into a catastrophe, in which case expert clinical care is needed to avoid poor outcomes.
While in the UK and other well-resourced countries a range of healthcare is available to mothers and their new-borns, in poor countries childbirth remains a very dangerous time for mothers and their babies. Mothers and babies in poor countries often do not have access to the healthcare, services or education available in the developed world. Often mothers in labour or suffering severe complications need to walk many miles to seek medical treatment, and when they reach a health facility, they often receive limited care due to lack of drugs, equipment or trained and supported staff.
Researchers at the University are researching new therapies to treat some of the main causes of death during pregnancy and childbirth, including post-partum haemorrhage. In collaboration with WHO, we are working on testing a heat-stable drug to prevent bleeding after childbirth. As it is heat-stable, it does not need to be kept refrigerated. This is essential in poor countries where electricity is limited and there may be little to no access to refrigeration.
Sepsis is a severe infection suffered by five million pregnant women across the world every year. If untreated, sepsis can cause septic shock and lead to organ failure. This can be fatal and in low-income countries, a third of pregnant women who contract sepsis are likely to die compared to 0.05% of pregnant women in the UK.
Dr David Lissauer is developing a bundle of care for women with suspected sepsis, in partnership with WHO. The bundle, called FAST-M, will contain tests and treatments which can be used by any healthcare provider. FAST-M bundle has the potential to save thousands of lives. Dr Lissauer is working with healthcare workers, women and community leaders in Sub-Saharan Africa and elsewhere to test and implement the FAST-M bundle.
Professor Coomarasamy is the founding trustee of Ammalife, a UK-registered charity with a global mission to reduce maternal death in low-income countries. Dr Coomarasamy set up Ammalife in 2007 to tackle the global inequalities in women’s healthcare. Ammalife conducts research in low-income countries to propose new solutions and ways to prevent needless deaths of mothers and babies. It also invests in local ‘change makers’ who are committed and trusted individuals who make significant contribution to maternal health.
Professor Coomarasamy and Dr Lissauer are currently conducting a large clinical trial, funded by the Medical Research Council, to define the role of prophylactic antibiotics in miscarriage surgery (AIMS Trial). Surgery for miscarriage management is one of the most common operations in low-resource countries, and can result in serious and sometimes fatal infection.
The AIMS trial proposes that if antibiotics are taken prior to miscarriage surgery, the chance of infection occurring could be reduced.
Director, Birmingham Clinical Trials Unit (BCTU)
Professor of Gynaecology
Institute of Metabolism and Systems Research
Institute of Applied Health Research
Find out more