(Abstracted from New Engl J Med 2018;379:743–752)
Postpartum hemorrhage is the most common cause of maternal death. Oxytocin is the standard therapy for the prevention of postpartum hemorrhage, but it requires cold storage, which is not available in many countries, and has unsatisfactory real-world efficacy as a result of heat sensitivity and quality issues such as insufficient active ingredient or impurities.
Department of Reproductive Health and Research, World Health Organization, United Nations Development Program–United Nations Population Fund–UNICEF–WHO–World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva, Switzerland (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.); Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.), Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.); S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka; Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.); Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.), India; Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.); Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.), United Kingdom; Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); Effective Care Research Unit, Universities of Witwatersrand–Johannesburg, Fort Hare–Alice, and Walter Sisulu–Eastern Cape, and Eastern Cape Department of Health, Eastern Cape, South Africa (G.J.H.); Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.)