Maternal Health
Post-partum haemorrhage (PPH) is defined as blood loss of 500mL or more within the first 24 hours after birth.
It is the leading direct cause of maternal mortality globally, with almost a fifth of maternal deaths attributable to PPH. Each year there are an estimated 14 million cases of PPH, and approximately 120,000 deaths, with almost all of this burden falling on women living in LMICs.
Although PPH affects one in six women giving birth, generalised use of high quality uterotonic agents in prevention and treatment, ready access to second line therapeutics such as hemostatic agents and blood products, and provision by highly skilled practitioners has virtually eliminated maternal deaths from PPH in high-income countries. However, it remains the leading cause of maternal mortality in LMICs. Oxytocin is the uterotonic of choice for management of PPH, but in its standard form requires refrigerated transport and storage, and administration by skilled health workers; neither of which are consistently available in low resource settings. Reducing maternal mortality from PPH in LMICs requires novel approaches tailored to low-resource contexts. There is ongoing development of alternative preparations of oxytocin and other medicines that are heat-stable, easy-to-administer and affordable. Low-tech devices that control bleeding have also been specifically developed for the treatment of PPH as adjunct therapies, or when first line treatments have failed.
Monash University and industry partners have been developing heat stable inhaled oxytocin, recently announcing a Phase I trial of the ICOone inhaler, developed by Sweden’s Iconovo. Medicated gauze repurposed from topical wound care are in development for PPH. The PPH-specific Celox chitosan gauze, CELOX PPH Uterine Hemostatic Tamponade, received CE certification in Europe in November 2022.