Misoprostol could play an important part in reducing complications of delivery in developing countries

A relatively cheap and easy to use drug could save the lives of thousands of women in the developing world, according to a study in this week's British Medical Journal.

Postpartum haemorrhage (excessive blood loss after childbirth) is the leading cause of maternal death in Africa. Several drugs reduce blood loss, but in poor areas they are often inaccessible, too expensive, and too difficult to use.

The study took place in Guinea-Bissau, West Africa, where maternal death is more than 8 per 1000 live births. Immediately after delivery, 330 women received misoprostol tablets and 331 received placebo (dummy pills).

Significantly fewer women in the misoprostol group experienced severe blood loss.

In rural Guinea-Bissau, 75% of women give birth at home, and worldwide only about 50% of women give birth in health facilities. So strategies are needed to increase the safety of deliveries attended by unskilled birth attendants, say the authors.

"Our trial suggests that misoprostol would play an important part in such a strategy to reduce complications of delivery and maternal mortality," they conclude.

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