Stanton, Cynthia, Samuel Newton, Luke Mullany, Patience Cofie, Charlotte Taiah Agyemang, Edward Adiibokah, Seeba Amenga-Etego, Niamh Darcy, Sadaf Khan, Deborah Armbruster, John Gyapong, and Seth Owusu-Agyei. “Effect on Postpartum Hemorrhage of Prophylactic Oxytocin (10 IU) by Injection by Community Health Officers in Ghana: A Community-Based, Cluster- Randomized Trial.” PLOS Medicine 10, no. 10 (October 2013). doi. 10.1371/journal.pmed.1001524.

URL: www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001524

ABSTRACT:

Oxytocin (10 IU) is the drug of choice for prevention of postpartum hemorrhage (PPH). Its use has generally been restricted to medically trained staff in health facilities. We assessed the effectiveness, safety, and feasibility of PPH prevention using oxytocin injected by peripheral health care providers without midwifery skills at home births.

Stanton et al conducted a community based cluster-randomized trial in Ghana to assess the efficacy of administering oxytocin to women just after delivery via pre-filled syringes (called the Uniject device) to prevent postpartum hemorrhaging (PPH). The authors found that the rate of PPH was reduced by half when the oxytocin-filled Uniject device was used. Importantly, there were no instances where oxytocin was administered prior to delivery, which would be unsafe for mother and child, and the device was successfully used by unskilled birth attendants during home births. Because over 50% of women in sub-Saharan Africa give birth at home, where the risk of PPH is greatest, the introduction of this intervention could make a significant contribution to maternal survival these areas. See the accompanying commentary by Joao Paulo Souza for a detailed discussion of the advantages and limitations of using the oxytocin-filled Uniject for the prevention of PPH.  HDN readers should note that the Stanton study was funded by PATH who commissioned and patented the Uniject device.