SynthesisPloS one2020
Quality of medicines for life-threatening pregnancy complications in low- and middle-income countries: A systematic review.
Synthesis in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- What do healthcare providers think of the quality of uterotonics? A mixed-methods systematic review.BMJ open · 2023Pooled it
- Assessing the quality of antenatal corticosteroids in low- and middle-income countries: A systematic review.PloS one · 2020Pooled it
- A phase 1 evaluation of inhaled oxytocin: Physiologically-based pharmacokinetic model informed dosing of a novel heat-stable oxytocin delivery system.British journal of clinical pharmacology · 2026Trial
- Moving beyond a legacy paradigm: A vision for equitable access to quality medicines in Africa.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Igniting the spark in six countries to transform the trajectory of postpartum hemorrhage across the globe: An overview of the AMPLI-PPHI project.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Review
- From guesstimates to game changers: Introducing objective measurement of blood loss for timely postpartum hemorrhage detection in Nigeria, Zambia, and Kenya.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Dose-response evaluation of intravenous carbetocin for prevention of postpartum haemorrhage during elective caesarean delivery: A parallel-group randomised controlled trial.Indian journal of anaesthesia · 2026Article
- Emergency medical team interventions involving pregnant patients of the Warmian-Masurian Voivodeship (Poland) in 2020-2022.BMC pregnancy and childbirth · 2026Article
- Perspectives of obstetricians and midwives on the preference for caesarean deliveries: a qualitative exploration in Andhra Pradesh, India.BMC pregnancy and childbirth · 2025Article
- FIGO call to action: Multisectoral approach to postpartum hemorrhage.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Article
- Analyzing caesarean sections through the Robson classification in Nigeria: a prospective nationwide study in referral level facilities.EClinicalMedicine · 2025Article
- The economic and health impact of substandard uterotonic use for prevention of postpartum hemorrhage in three Sub-Saharan African countries: a comparative analysis.Health research policy and systems · 2025Article
- Burden and trend of maternal sepsis and other maternal infections in BRICS countries from 1990 to 2021.BMC pregnancy and childbirth · 2025Article
- Modeling the economic and health impact of substandard uterotonics in Senegal.BMC pregnancy and childbirth · 2025Article
- Cost-effectiveness results comparing heat-stable carbetocin & other uterotonics in postpartum heamorrhage prevention in Uganda.PLOS global public health · 2025Article
- Modelling the economic impact of substandard uterotonics on postpartum haemorrhage in Nigeria: safeguarding medicine quality can reduce costs and contribute towards universal health coverage.BMJ public health · 2025Article
- An Implementation Research Study on Uterotonics Use Patterns and Heat-stable Carbetocin Acceptability and Safety for Prevention of Postpartum Hemorrhage in Nigeria.International journal of MCH and AIDS · 2024Article
- Introduction of Heat-Stable Carbetocin through a Public-Private Partnership Model in India: A Retrospective Study to Determine Feasibility and Its Optimal Use in Public Health Settings.International journal of MCH and AIDS · 2024Article
- A randomized controlled study comparing oral misoprostol with intramuscular oxytocin in active management of third stage of labour.Obstetrics & gynecology science · 2024Article
- Modeling the economic burden of postpartum hemorrhage due to substandard uterotonics in Ghana.PLOS global public health · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundThere are concerns about the quality of medicines available in low- and middle-income countries (LMIC) to manage hemorrhage, pre-eclampsia/eclampsia and sepsis. We aimed to identify, critically appraise, and synthesize the findings of studies on the quality of these three types of medicines available in LMIC.
methodsThis systematic review searched Medline, EMBASE and LILACS (from inception to 25 May 2020) for studies on the quality of selected medicines available in LMIC that provided at least the amount of active pharmaceutical ingredient. We contacted study authors for additional information. We excluded simulation studies. We used the MEDQUARG tool to assess study quality. The main outcome was the prevalence of failed samples.
findingsWe identified 9699 unique citations and included 34 studies (3159 samples from 40 countries) in the review. Most studies (65%) had low quality (scores <6/12). Overall, 48.9% of 1890 uterotonic samples (19 studies) failed quality tests; failures rates were 75% for ergometrine and nearly 40% each for oxytocin and misoprostol. The overall prevalence of failed injectable antibiotics (1090 samples, 18 studies) was 13.4%, ranging from 2.9% for injectable metronidazole (34 samples, 3 studies) to 16.0% for cefazolin (449 samples, 2 studies). The prevalence of low quality magnesium sulphate (179 samples, 2 studies) was 3.4%. We did not find any studies on the quality of carbetocin, tranexamic acid, or clindamycin.
conclusionsThere is a widespread problem with the quality of medicines used to manage life-threatening maternal conditions in LMIC. This can be a contributing factor to high maternal mortality rates in these regions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.