Study identifies cost-effective solutions to prevent and treat postpartum hemorrhage

A new study has found that care bundles and medication used to treat or prevent excessive blood loss are cost-effective ways of addressing postpartum hemorrhage—the leading cause of maternal deaths in limited-resource settings.

Postpartum hemorrhage is a life-threatening medical emergency that occurs after childbirth.

Burnet public health registrar Dr. Joshua Ginnane is the first author of the paper, “The cost-effectiveness of preventing, diagnosing, and treating postpartum hemorrhage: a systematic review of economic evaluations” published in PLOS Medicine.

“The study was designed to analyze and compare the most cost-effective interventions for preventing, diagnosing, and treating postpartum hemorrhage,” he said.

“We identified 56 studies across 16 interventions, summarized the findings from these studies in a comparable way and identified those which are effective and cost-effective.”

He said analyzing the cost of treatments for postpartum hemorrhage in low-income areas would help ensure limited health care resources were used effectively.

“By carefully looking at which treatments are the most cost-effective, governments can ensure their spending has the biggest impact,” Dr. Ginnane said.

The study found that combining simultaneous interventions into a care bundle to prevent, diagnose and treat the condition could save costs.

Care bundles can include administering preventative uterotonic drugs, used to induce contraction, quantitative blood loss measurement and tiered treatment responses.

“There are many different interventions for postpartum hemorrhage. We found consistent evidence that for postpartum hemorrhage treatment, adding tranexamic acid to more traditional treatments like uterotonics, was cost-effective across a broad range of settings,” Dr. Ginnane said.

Several important treatments recommended by the World Health Organization—such as special garments to treat shock, or devices to stem bleeding—still need stronger evidence to prove they are cost-effective in diverse settings.

“Further research will be crucial to better understand which strategies are most cost-effective to combat postpartum hemorrhage and ensure life-saving interventions are accessible to all women,” Dr. Ginnane said.