World Patient Safety Day 2022: medication safety for the prevention and treatment of postpartum haemorrhage (PPH)
Marking World Patient Safety Day 2022
Medication-related harm accounts for up to half of the overall preventable harm in medical care. Patients in low- and middle-income countries are twice as likely to experience preventable medication harm than patients in high-income countries. Considering this huge burden of harm, the World Health Organization has selected “medication safety” as the theme for World Patient Safety Day 2022 on 17 September.
Medication safety and postpartum haemorrhage (PPH)
At FIGO, we are using this day to highlight the vital importance of medication safety for the prevention and management of postpartum haemorrhage (PPH). PPH occurs in around 3%–5% of all births and approximately 25% of the annual 300,000 maternal deaths are related to complications of PPH.
In June 2022, FIGO’s Improve Access to essential medicines to reduce PPH morbidity and mortality Project (IAP) published an open access supplement on ‘Improving access to essential medicines to reduce postpartum haemorrhage morbidity and mortality’ in the International Journal of Gynecology and Obstetrics (IJGO), providing seven original contributions on medicines and the management of PPH.
Watch the FIGO World Patient Safety Day 2022 video to find out about the contents of this supplement focusing on issues related to policy, practice, innovations and medicines in the pipeline for the prevention and management of PPH.
Read the full ‘Improving access to essential medicines to reduce postpartum haemorrhage morbidity and mortality’ supplement.
Important note
As tranexamic acid (TXA) is more widely available and its use in the treatment of PPH increases, the WHO PPH Guidelines 2017/18 layout the specific recommendations on best practice for its safe and effective use.
|
Indication |
Dosing |
Timing |
|
Use TXA in all cases of PPH, regardless of whether the bleeding is due to genital tract trauma or other causes. |
Use TXA within three hours and as early as possible after the onset of PPH. Do not initiate TXA more than three hours after birth, unless being used for bleeding that restarts within 24 hours of completing the first dose (see dosing). |
Fixed dose of 1g in 10 ml (100mg/ml) IV at 1 ml per minute (i.e., administered over 10 minutes) Second dose of 1g IV if bleeding continues after 30 minutes or if bleeding restarts within 24 hours of completing the first dose. |
It should be noted that TXA is not an alternative to oxytocin which remains the uterotonic of choice for the prevention of PPH.
For further guidance on the safe use of PPH medications, including TXA and heat-stable carbetocin (HSC) you can refer to the WHO Guidelines or download the FIGO Generic PPH Protocol and Care Pathways.
Resources
FIGO Generic Postpartum Haemorrhage Protocol and Care Pathways document, available in English and French.
Updated WHO Recommendation on Tranexamic Acid for the Treatment of Postpartum Haemorrhage (2017)
WHO recommendations Uterotonics for the prevention of postpartum haemorrhage (2018)