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| 13 Jul 2010 Nick Henwood |
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| WHO's 2009 guidlines are cautious, but futher evidence presented in the Lancet suggests that a significant reduction in maternal mortality can be achieved at the lowest level of healthcare provision using mesoprostol by mouth or rectally. |
Here is a quote from the Lancet article promoting wider use of mesoprostol:
"For prevention of post-partum haemorrhage, pregnant women delivering at home without a skilled birth attendant can self-adminster 600 ug misoprostol orally as soon as possible after the baby is delivered.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60750-7/fulltext
Here is the introduction to WHO's cautious guidelines:
Postpartum haemorrhage is a major cause of maternal mortality. The World Health Organization recommends that active management of the third stage of labour must be offered to all women delivered by skilled birth attendants during childbirth to prevent postpartum haemorrhage. This package of interventions includes administration of oxytocin (10 international units by injection), clamping and cutting of the cord at around 3 minutes after birth, and delivery of the placenta by controlled cord traction. The objective of this statement is to explain current WHO position regarding misoprostol use after childbirth.
For full text see:
http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/misoprostol/en/index.html
Image - thanks to UNICEF
http://fieldnotes.unicefusa.org/2008/08/in_india_motherstobe_call_help_1.html
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