Postpartum hemorrhage (PPH) is the leading cause of maternal death globally. In 2018, the World Health Organization (WHO) updated its guideline for the prevention and treatment of PPH to include the addition of heat stable carbetocin (HSC) for the prevention of PPH. Oxytocin (10 IU) is still recommended for prevention and treatment of PPH in settings where multiple uterotonic options are available. However, in settings where oxytocin is unavailable (or its quality cannot be guaranteed), the use of other injectable uterotonics, such as HSC or oral misoprostol is recommended for the prevention of PPH.
To complement these changes, WHO published a revised Essential Medicines List in 2019 that includes HSC and another product—tranexamic acid—which both bolster the toolkit available for PPH. The updated Essential Medicines List adds 28 medicines for adults and 23 for children and specifies new uses for 26 already-listed products, bringing the total to 460 products deemed essential for addressing key public health needs.
