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APHA Scientific Session and Event Listing

Recorded presentation

Rd Derman, MD¹, BS Kodkany, MD², Sa Edlavitch, PhD¹, SS Goudar, MD³, Stacie E. Geller, PhD⁴, and VA Naik². (1) OB/GYN, UMKC School of Medicine, 2411 Homes Street, M5-105, Kansas City, MO 64108, 816-235-6617, edlavitchs@umkc.edu, (2) JNMC, Belgaum, Karnataka, 590 010, India, (3) Global Network for Women's and Children's Health Research Site 8, J N Medical College, Nehru Nagar, Belgaum Karnataka, 590 010, India, (4) Obstetrics and Gynecology, University of Illinois at Chicago, 820 S. Wood Street, M/C 808, Chicago, IL 60612

Postpartum hemorrhage (PPH) is the largest cause of maternal deaths around the world and is particularly important in developing countries. Annually, 25% of the 515,000 maternal deaths worldwide are due to PPH, the majority of these due to atonic hemorrhage. The majority of women (2/3) have no known identifiable risk factors. This presentation will: 1. Report on an NICH funded double-blind clinical trial to test the effectiveness of an oral uterotonic (Misoprostol) administered during the 3rd stage of labor in 1620 non-hospital deliveries in low risk pregnancies in rural India; the hypothesis tested that regular administration of an oral uterotonic will reduce PPH rates by 50%; 2. Discuss the contributions of oral uterotonics, objective measurement of blood loss following delivery and training to improve delivery practices of field health workers to reducing PPH; and 3. Report on consensus meetings with public health officials in India and other developing countries of how these findings may be put into practice. Though the trial is completed and was successful, the numerical findings cannot be included in this abstract due to publication restrictions in place until May, 2006. A Congress on developing public health policy for implementation in India and other developing countries will be held in Goa, India, July 2006. The major findings of the clinical trial and consensus policy recommendations of the Indian and other public health officials participating in the Congress will be summarized in this APHA session.

Learning Objectives: At the conclusion of this session, the learner will

• Learn about the effectiveness of administering Misoprostol at delivery by Nurse Midwives in non-hospital rural settings.
• Recognize factors related to improving delivery outcomes in rural settings in developing countries.

Keywords: Mortality, Developing Countries

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation