Hadiza Galadanci, a professor of obstetrics and gynaecology in Nigeria, has presented the results of her research into the prevention and treatment of Postpartum haemorrhage (PPH) — excessive bleeding after childbirth — to prevent two million maternal and infant deaths worldwide by the year 2030.
She discussed the use of a calibrated obstetric drape in the E-MOTIVE study to detect excessive blood loss and the use of an intravenous iron infusion that can be administered in as little as 15 minutes to treat severe anaemia in pregnant women as two examples of her innovations.
She stated, “I could save one or two lives at a time as an obstetrician, while I could save 100,000 lives by becoming a medical researcher, so I decided to focus my research on areas that affect the lives of women, such as PPH”.
“PPH is the number one cause of maternal deaths, not just in Nigeria, but all over the world. 14 million women experience this every year, and approximately 70,000 die from it. In a study, we call the E-MOTIVE. I discovered that half of the women who have PPH are never even diagnosed. That’s because health care workers are busy and struggle with how much blood loss is too much blood loss.’’
She explained that the innovation consists of a simple drape placed at the bedside, allowing for rapid and accurate blood measurement. This new development may mean the difference between life and death in a crowded labour and delivery unit.
“Our study also found out that when PPH is identified, the standard treatment of uterus massage, oxytocic drugs tranexamic acid, IV fluids, and genital tract examination are often delivered one by one over several hours."
“We asked ourselves, why don’t we bundle these interventions, administering all five at once and so we tried it and we decreased cases of severe bleeding by 60 per cent."
“Often, we didn’t need anything complicated to save lives; just drape and change of protocol. But the simple changes have huge benefits, lifesaving benefits, cuts to research without a doubt."
“Imagine a world where these treatments are available in every one-room clinic, every labour ward, and every hospital, how many mothers would be saved? That’s the work that is left for us to do.”
Galadanci remarked that she felt compelled to work to improve the lot of women and reduce neonatal mortality because of the high rates of maternal mortality in Nigeria.
She spoke about the tragic deaths of women she knew, including her cousin and others, as a result of excessive bleeding during childbirth.
“I’ve seen women, wishing the death of their children to save them from the cycle of pain and poverty, they had to endure themselves."
“These women are my neighbours, they’re my friends and even my family."
The researcher described an incident involving her first cousin, who was in her fourth trimester of pregnancy and had high blood pressure. They opted to induce her for a natural birth out of concern for her health.
While she was at work doing her regular hospital duties, the labour progressed normally.
“After a while and walked into the labour ward to check on. What I saw, never left me, blood was flowing out of her like a tube, I put on my gloves and began massaging in the uterus."
“Using all the drugs I had tried to stop the bleeding. But it wasn’t working. She was looking up at me, begging me to look after her babies after her death. At that moment, it was hard to think as a physician."
"At that moment. I was just her cousin. We performed a hysterectomy and blood transfusion. We gave her six pints of blood."
“That’s almost the whole blood volume of a woman and until the next morning, what she had every inhale and exhale until I knew she had made it."
“Not everyone is so lucky to have a family member who is an obstetrician. I couldn’t stop thinking about how unfair that was,’’ Galadanchi said.