ArticleBMC pregnancy and childbirth2014
Modeling maternal mortality in Bangladesh: the role of misoprostol in postpartum hemorrhage prevention.
Article in BMC pregnancy and childbirth, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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17 citing papers in PubMed, 27 citations in OpenAlex.
- Women's empowerment and health facility utilization during childbirth in Cameroon.BMC women's health · 2026Article
- Factors associated with institutional delivery in south Asian countries: evidence from five recent demographic and health surveys.Research in health services & regions · 2025Article
- Management of Postpartum Hemorrhage in Low- and Middle-Income Countries: Emergency Need for Updated Approach Due to Specific Circumstances, Resources, and Availabilities.Journal of clinical medicine · 2024Review
- Determinants of home delivery among reproductive age women in Bore District, East Guji Zone, Ethiopia: a case-control study.Frontiers in global women's health · 2024Article
- Maternal mortality in Bangladesh: Who, when, why, and where? A national survey-based analysis.Journal of global health · 2023Article
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- Determinants of Utilization of Institutional Delivery Services in Zambia: An Analytical Cross-Sectional Study.International journal of environmental research and public health · 2022Article
- Individual and Community-Level Determinants of Institutional Delivery Services among Women in Bangladesh: A Cross-Sectional Study.International journal of clinical practice · 2022Article
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- Effects of COVID-19 on maternal institutional delivery: Fear of a rise in maternal mortality.Journal of global health · 2021Article
- Article
- Implementation of community based advance distribution of misoprostol in Himachal Pradesh (India): lessons and way forward.BMC pregnancy and childbirth · 2018Article
- Trend and Causes of Maternal Mortality in a Nigerian Tertiary Hospital: A 5-year Retrospective Study (2010-2014) at the University of Calabar Teaching Hospital, Calabar, Nigeria.Open access Macedonian journal of medical sciences · 2018Article
- Cost effectiveness of mHealth intervention by community health workers for reducing maternal and newborn mortality in rural Uttar Pradesh, India.Cost effectiveness and resource allocation : C/E · 2018Article
- Factors associated with the utilization of institutional delivery services in Bangladesh.PloS one · 2017Article
- A New Look at Care in Pregnancy: Simple, Effective Interventions for Neglected Populations.PloS one · 2016Review
- Utilization of research findings for health policy making and practice: evidence from three case studies in Bangladesh.Health research policy and systems · 2015Article
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBangladesh is one of the few countries that may actually achieve the fifth Millennium Development Goal (MDG) in time, despite skilled birth attendance remaining low. The purpose of this paper is to examine the potential role misoprostol can play in the decline of maternal deaths attributed to postpartum hemorrhage (PPH) in Bangladesh.
methodsUsing data from a misoprostol and blood loss measurement tool feasibility study in Bangladesh, observed cause specific maternal mortality ratios (MMRs) were estimated and contrasted with expected ratios using estimates from the Bangladesh Maternal Mortality Survey (BMMS) data. Using Crystal Ball 7 we employ Monte Carlo simulation techniques to estimate maternal deaths in four scenarios, each with different levels of misoprostol coverage. These scenarios include project level misoprostol coverage (69%), no (0%), low (40%), and high (80%) misoprostol coverage. Data on receipt of clean delivery kit, use of misoprostol, experience of PPH, and cause of death were used in model assumptions.
resultsUsing project level misoprostol coverage (69%), the mean number of PPH deaths expected was 40 (standard deviation = 8.01) per 100,000 live births. Assuming no misoprostol coverage (0%), the mean number of PPH deaths expected was 51 (standard deviation = 9.30) per 100,000 live births. For low misoprostol coverage (40%), the mean number of PPH deaths expected was 45 (standard deviation = 8.26) per 100,000 live births, and for high misoprostol coverage (80%), the mean number of PPH deaths expected was 38 (standard deviation = 7.04) per 100,000 live births.
conclusionThis theoretical exercise hypothesizes that prophylactic use of misoprostol at home births may contribute to a reduction in the risk of death due to PPH, in addition to reducing the incidence of PPH. If findings from this modeling exercise are accurate and uterotonics can prevent maternal death, misoprostol could be the tool countries need to further reduce maternal mortality at home births.
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