Gynuity Health Projects


Postpartum Hemorrhage Overview

Hemorrhage is the largest single cause of maternal death, accounting for about one-fourth of maternal mortality. Misoprostol is promising in two aspects of morbidity reduction:

  • by preventing the onset of postpartum hemorrhage when used after delivery of the placenta as part of the management of the third stage of labor; and
  • by treating postpartum hemorrhage, either after previous prophylaxis has failed or where no prophylaxis has been given.

Misoprostol stimulates uterine contractions, which may effectively prevent or end bleeding after delivery. It may be especially important in settings where no other effective drugs are currently available for prevention or treatment of postpartum hemorrhage.

Gynuity recently completed the first phase of a large-scale project to evaluate misoprostol for postpartum hemorrhage prevention and treatment and to help raise awareness about its potential, especially in low-resource settings where it could have the greatest impact. In November, 2009, The Bill and Melinda Gates Foundation awarded Gynuity a $25 million, 5-year grant to implement a series of new research and advocacy activities building upon the success of the initial project.

Gynuity Activities

Under the new grant, some of the specific research and program approaches in the five-year body of work include:

  • development and implementation of studies to identify pathways for the safe and effective use of misoprostol for PPH prevention and treatment for use outside of tertiary level facilities;
  • development of an evidence-based policy and advocacy agenda in partnership with key international and regional organizations;
  • creation of new clinical knowledge on misoprostol for PPH indications;
  • encouragement of policy change at national and international levels;
  • creation of informational materials for use by various audiences to address issues of access to interventions to prevent and treat PPH; and
  • collaboration with pharmaceutical entities to push for greater availability of misoprostol for PPH care.

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