Tranexamic acid, an overlooked drug designed in the 1960s, has been tried once more to test its effectiveness in stopping postpartum hemorrhaging.
It was invented by female doctor Utako Okamoto, who developed the drug to help save women’s lives during the painful but rewarding labor of childbirth.
The drug was tested once more at London School of Tropical Medicine and Hygiene, due to Okamoto being unable to convince her colleagues that the drug was effective.
Saving mothers during childbirth
Postpartum hemorrhaging is the leading cause of death during pregnancy, being the reason behind 44,000 to 100,000 deaths each year globally. The rates appear to increase in poorer countries, as in the United Kingdom 0.4 women out of 100,000 dying from postpartum hemorrhaging, while in sub-Saharan Africa the rate stands at 150 women per 100,000.
The cause behind 7 out of 10 cases of postpartum hemorrhaging is uterine atony, which is when the uterus is unable to contract correctly, which in turn leads to vast amounts of bleeding. Other causes may include trauma to the genitals, holding back the placenta or the fetus, and lastly, when the blood fails to clot moments after the child has been born.
Usually, postpartum hemorrhaging is treated with oxytocin to help the uterus contract. Luckily, it appears that tranexamic acid can be used safely alongside oxytocin.
It was Okamoto’s vision to reduce the risk as much as possible, which is why she devised tranexamic acid to help mothers during childbirth. However, since she was not allowed to test the drug in real circumstances, it remained in obscurity for years, except for trials where it was tested to help against bleeding from external injuries.
Now, Haleema Shakur from the London School of Tropical Medicine and Hygiene is leading efforts to prove that tranexamic acid does help prevent the risk of death from hemorrhaging after childbirth at least by a third.
To study the drug, it was administered to 20,000 women who were suffering from postpartum hemorrhaging in 200 hospitals and from 21 different countries of different levels of development. They were given either a dose of tranexamic acid or a placebo. 1.2 percent of those receiving the tranexamic acid died, compared to 1.7 percent of those who received the placebo.
Researchers propose that tranexamic acid should be used as soon as possible after bleeding onset. It acts by inhibiting how the womb gets torn during childbirth, being able to reduce blood loss by about a third.
Besides being effective, the drug is incredibly cheap, costing only $1 per dose, and even less depending on the country where it’s manufactured.
“Tranexamic acid offers an additional benefit above and beyond what is being done for women already. That’s, I think, the million dollar question. We in global health have a number of tools that seem very effective in large clinical trials. But then when it comes time to use them for all women, we see very large gaps in implementation,” stated Margaret Kruk, a global health researcher at Harvard University to NPR.
The drug also does not cause any notable side-effect.
Source: The Lancet