A Nigerian Professor of Obstetrics and Gynecology, Hadiza Galadanci, has shared her research innovations on the treatment of Postpartum haemorrhage (PPH).
PPH is excessive bleeding and loss of blood after childbirth. It means losing more than half a litre of blood within 24 hours of childbirth.
Galadanci, a Professor of Obstetrics and Gynecology at the College of Health Sciences, Bayero University Kano, shared her research innovations at the 2023 Goalkeepers event at the ongoing 78th session of the UN General Assembly.
The innovations are a calibrated obstetric drape used in an E-MOTIVE study to detect excessive blood loss and a 15-minute IV iron infusion to treat severe anaemia in pregnant women.
These innovations aim to save two million lives by 2030, addressing maternal and child mortality issues worldwide.
Speaking at the Sustainable Development Goals (SDGs) Pavilion at UN headquarters in New York, she told the audience that she could save more lives by being a medical researcher than being an obstetrician.
“I could save one or two lives at a time as an obstetrician, while I could save 100,000 lives by becoming a medical researcher, so I decided to focus my research on areas that affect the lives of women, such as PPH.
“PPH is the number one cause of maternal deaths, not just in Nigeria, but all over the world. 14 million women experience this every year, and approximately 70,000 die from it.
“In a study, we call the E-MOTIVE. I discovered that half of the women who have PPH are never even diagnosed. That’s because health care workers are busy and struggle with how much blood loss is too much blood loss.’’
According to her, a simple drape at the edge of the bed can see a fast and accurate measurement of collected blood, noting that in a busy labour ward, this can be the difference between life and death.
“Our study also found out that when PPH is identified, the standard treatment of uterus massage, oxytocic drugs tranexamic acid, IV fluids and genital tract examination are often delivered one by one over several hours.
“We asked ourselves, why don’t we bundle these interventions, administering all the five at once and so we tried it and we decreased cases of severe bleeding by 60 per cent.
“Often, we didn’t need anything complicated to save lives; just drape and change of protocol. But the simple changes have huge benefits, lifesaving benefits, cuts to research without a doubt.
“Imagine a world where these treatments are available in every one-room clinic, every labour ward and every hospital, how many mothers would be saved? That’s the work that is left for us to do.”
Galadanci, who is the first female Professor of gynaecology in northern Nigeria, has received global recognition from the Bill and Melinda Gates Foundation for her innovations in improving maternal and newborn mortality.
Galadanci said the high burden of maternal deaths in Nigeria challenged her to come up with a solution to help reduce the suffering of women and reduce newborn mortality.
She shared the experience of her cousin and other women, saying, I have watched life leave a woman’s body as she bleeds out while giving birth.
“I’ve seen women, wishing the death of their children to save them from the cycle of pain and poverty, they had to endure themselves.
“These women are my neighbours, they’re my friends and even my family."
According to the researcher, her first cousin, whom she loves dearly, is one such woman who on her fourth pregnancy had high blood pressure.
Moved by her case, she said they decided to induce her for normal labour and she went into labour normal practice as she went about her business in the hospital, doing my rounds and caring for other patients.
“After a while and walked into the labour ward to check on. What I saw, never leaves me, blood was flowing out of her like a tube, I put on my gloves and began massaging in the uterus.
“Using all the drugs I had tried to stop the bleeding. But it wasn’t working. She was looking up at me, begging me to look after her babies after her death. At that moment, it was hard to think as a physician.
“In that moment. I was just her cousin. We performed a hysterectomy and blood transfusion. We gave her six pints of blood.
“That’s almost the whole blood volume of a woman and until the next morning, what she had every inhale and exhale until I knew she had made it.
“Not everyone is so lucky to have a family member who is an obstetrician. I couldn’t stop thinking about how unfair that was,’’ Galadanchi said.