Maternal Mortality: A Global Challenge

Childbirth is a miraculous and transformative event, but it can also pose significant risks to both the mother and the baby. Among the various complications that can occur, postpartum hemorrhage (PPH) stands out as a major concern. PPH, characterized by excessive bleeding after childbirth, accounts for a staggering 27% of all maternal deaths globally, according to the World Health Organization (WHO). 

E-MOTIVE Study: Changing the Game for Postpartum Hemorrhage (PPH) Management

E-MOTIVE is a breakthrough solution published in a landmark study by researchers from the WHO and the University of Birmingham (1-2). The E-MOTIVE trial was designed to evaluate whether a new solution can address the critical issue of postpartum hemorrhage by focusing on early detection and timely treatment. More specifically, the trial aims to evaluate whether these proactive measures can effectively reduce the amount of blood loss experienced by mothers, ultimately leading to improved maternal health outcomes. 

One of the key obstacles in effectively treating postpartum hemorrhage (PPH) lies in the delay or inaccurate detection of the condition. The current reliance on visual estimation for PPH diagnosis has proven to be unreliable and often leads to underestimation of blood loss. Recognizing this critical issue, the E-MOTIVE trial proposes an innovative solution - the use of calibrated blood-collection drapes to provide an objective estimation of blood loss.

In addition to addressing the diagnostic challenges associated with PPH, the E-MOTIVE trial also aims to revolutionize the treatment approach. Traditionally, PPH treatments have been sequential, resulting in valuable time wasted between each intervention. Recognizing the urgency of prompt and timely action, E-MOTIVE has implemented the early and simultaneous treatment protocol proposed by the WHO. As per WHO recommendations, E-MOTIVE’s treatment protocol is made up of a comprehensive range of interventions, including the uterine massage, use of oxytocic drugs (oxytocin and misoprostol), tranexamic acid, intravenous fluids, thorough physical examination of the patient and birth canal, and escalating to other procedures if bleeding does not stop. 

The results of the E-MOTIVE trial, which focused on early detection and timely treatment of postpartum hemorrhage (PPH), have unveiled a remarkable breakthrough in maternal care. The trial's findings showcase a significant reduction in maternal mortality, blood loss, and the need for laparotomy for PPH by an astounding 60%. Moreover, another notable achievement of the trial was the remarkable improvement in PPH detection rates. The group receiving the E-MOTIVE detection protocol demonstrated an impressive detection rate of 93.1%. In contrast, the group receiving usual care only achieved a detection rate of 51.1%. 

The findings of the E-MOTIVE trial underscore the significance of early detection and timely treatment in addressing postpartum hemorrhage (PPH). The combination of early recognition of PPH and a bundle of first-response treatments, including uterine massage, oxytocic drugs, tranexamic acid, intravenous fluids, thorough examination, and escalation, has proven to be an effective and safe strategy for reducing maternal morbidity and mortality while improving overall maternal health outcomes worldwide.

How Maternova's Obstetric Drape and Materna Well Tray are Revolutionizing Maternal Care

Maternova's calibrated obstetric drape is designed to measure blood loss accurately during childbirth, enabling early detection and treatment of postpartum hemorrhage (PPH) – a leading cause of maternal mortality. It's a simple, low-cost, and effective tool that can save lives anywhere, from high-resource hospitals to remote clinics in low-resource settings.

In addition, the MaternaWell Tray is an innovative, alternative approach to providing comprehensive and high-quality care during childbirth. The tray is a tool for blood loss measurement and includes all necessary tools and guidelines to assist healthcare providers in assessing and managing complications during childbirth effectively and efficiently.The Materna Well Tray has the benefit of being reusable — a critical element when working in low income settings.

These innovative devices not only improve the quality of care but also empower healthcare providers with the necessary tools to save lives.

Conclusion

Overall, the E-MOTIVE trial highlights the importance of investing in maternal health research and implementing evidence-based interventions, particularly in resource-poor settings, where maternal mortality rates are alarmingly high and there is an urgent need for effective strategies to safeguard the lives and well-being of mothers.

By embracing the findings of the E-MOTIVE trial, healthcare systems and policymakers can pave the way for improved maternal care on a global scale. These results highlight the need for comprehensive and integrated approaches that prioritize early detection, timely treatment, and the utilization of innovative diagnostic tools. Such investments in maternal health research and interventions can yield transformative outcomes, reducing the burden of PPH and ultimately saving countless lives.

1: https://www.who.int/news/item/09-05-2023-lifesaving-solution-dramatically-reduces-severe-bleeding-after-childbirth

2: https://www.birmingham.ac.uk/research/bctu/trials/womens/emotive/e-motive.aspx

Written by Dr. Nestor Ferrer, Ob/Gyn; Edited by Juan Lopez, Gabriela Salvador, and Kaitlyn Gosakti