Controlling postpartum hemorrhage after home births in Tanzania.
OBJECTIVE
Determine safety of household management of postpartum hemorrhage (PPH) with 1000 microg of rectal misoprostol, and assess possible reduction in referrals and the need for additional interventions.


METHODS
Traditional birth attendants (TBAs) in Kigoma, Tanzania were trained to recognize PPH (500 ml of blood loss). Blood loss measurement was standardized by using a local garment, the "kanga". TBAs in the intervention area gave 1000 microg of misoprostol rectally when PPH occurred. Those in the non-intervention area referred the women to the nearest facility.


RESULTS
454 women in the intervention and 395 in the non-intervention areas were eligible. 111 in the intervention area and 73 in the non-intervention had PPH. Fewer than 2% of the PPH women in the intervention area were referred, compared with 19% in the non-intervention.


CONCLUSIONS
Misoprostol is a low cost, easy to use technology that can control PPH even without a medically trained attendant.
Prata
N
N
Bixby Population Program, School of Public Health, University of California, Berkeley, 1213 Tolman Hall, Berkeley, CA 94720-1690, USA. ndola@berkeley.edu
Mbaruku
G
G
Campbell
M
M
Potts
M
M
Vahidnia
F
F
D000285:Administration, Rectal; D000293:Adolescent; D000328:Adult; D005260:Female; D006700:Home Childbirth; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008507:Medically Underserved Area; D016595:Misoprostol / Q000008:administration & dosage*; D010120:Oxytocics / Q000008:administration & dosage*; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011247:Pregnancy; D012017:Referral and Consultation / Q000706:statistics & numerical data; D013636:Tanzania; D016896:Treatment Outcome
D010120:Oxytocics; D016595:Misoprostol