New IJGO supplement: Improving access to essential medicines to reduce postpartum hemorrhage morbidity and mortality

pph supplement quote

FIGO’s Improve Access to essential medicines to reduce PPH morbidity and mortality Project (IAP) (2021 – 2022) has published an open access supplement in Issue 158(S1) of the International Journal of Gynecology and Obstetrics (IJGO). The supplement, published on 28 June 2022, provides seven original contributions on medicines and management of PPH. 

Postpartum hemorrhage (PPH) occurs in around 3%–5% of all births, with large regional variation. It is the leading cause of maternal deaths globally, and approximately one quarter of the annual 300,000 maternal deaths are related to complications of PPH.  

Supplement key findings 

Reducing the risk of death from PPH requires evidence-based care, innovation, and addressing demand- and supply-side bottlenecks around quality, availability, and use of uterotonics.  

Broadly, the papers in this new supplement cover policy and regulatory issues, research and development, including new medicines in the pipeline and new routes of administration of old medicines, addressing quality of medicines in low- and middle-income countries (LMICs). There are also strategies to improve PPH prevention and treatment. 

Key findings in the supplement highlight the importance of developing and disseminating context-specific, evidence-based PPH guidelines for improved quality of care and the critical role of innovation in the prevention and treatment of PPH. Quality assurance systems along the supply chain of essential medications are needed as an integral part of the health system for optimal outcomes. 

We hope that this supplement will improve awareness of the key issues around the prevention and treatment of PPH, including the implementation of current evidence-based recommendations, especially in LMICs.

– Dr Charles Ameh and Dr Fernando Althabe 

Read the full supplement 

Supplement overview 

The papers in the supplement are as follows:  

  • Improving postpartum hemorrhage care: Policy, practice, and research 
  • FIGO and the International Confederation of Midwives endorse WHO guidelines on prevention and treatment of postpartum hemorrhage 
  • Challenges in updating national guidelines and essential medicines lists in Sub-Saharan African countries to include WHO-recommended postpartum hemorrhage medicines.  
  • A synthesis of clinical and health system bottlenecks to implementing new WHO postpartum hemorrhage recommendations: Secondary data analysis of the Kenya Confidential Enquiry into Maternal Deaths 2014–2017. 
  • Differences in obstetric practices and outcomes of postpartum hemorrhage across Nigerian health facilities. 
  • Innovations in the prevention and treatment of postpartum hemorrhage: Analysis of a novel medicines development pipeline database. 
  • Alternative routes to intravenous tranexamic acid for postpartum hemorrhage: A systematic search and narrative review. 
  • Quality of oxytocin and tranexamic acid for the prevention and treatment of postpartum hemorrhage in Kenya, Nigeria, South Africa, and Tanzania. 

Read the full supplement 

Related FIGO statements 

FIGO and ICM Joint statement of recommendation for the use of tranexamic acid for the treatment of postpartum haemorrhage 

FIGO and ICM Joint statement of recommendation for the use of uterotonics for the prevention of postpartum haemorrhage