e motive

1. E-MOTIVE

Dr Baguma Steven
OBS & GYN –GRRH/MOH
08th 10 2022
Presented at: Kitgum
General Hospital

2. PPH Account

• Globally, PPH is the leading cause of Maternal Mortality
• WHO estimates 24M women experience PPH annually
• Accounts for 1 in 3 MDs (MPDSR FY 2022/2023)
10/8/2025
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3.

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• Early detection and treatment with the WHO MOTIVE
'first response' treatment bundle effectively controls
bleeding for most women who experience PPH (EMOTIVE)
• 60% reduction in severe PPH, 20% reduction in
mortality,30% reduced need for BT, and invasive
management
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5.

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6. E-MOTIVE

The E-MOTIVE intervention is a package of practices that
aim to reduce severe bleeding after childbirth.
It includes a blood-collection drape to detect postpartum
hemorrhage (PPH) early, and a treatment bundle to stop the
bleeding
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7.

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8. Components of the E-MOTIVE Bundle

E
• Early Detection (& Rx is important to prevent
complications) Using a Calibrated Drape
Objective: Accurate measurement of blood loss using an
under-buttocks calibrated drape.
Importance: Visual estimation is often inaccurate, leading
to underestimation and delayed response.
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9. Estimation of blood loss

• Use of calibrated blood collection drape
(EMOTIVE Cluster RCT)??
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10. M

• Uterine Massage
Objective: Stimulate uterine contractions to reduce
bleeding.
Technique: Firmly massage the uterus through the
abdominal wall until it is firm and contracted
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11. o

• Oxytocic Drugs
Objective: Induce uterine contractions pharmacologically.
Drugs Used: Oxytocin is the first-line drug, followed by
alternatives such as misoprostol if necessary.
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12. T

• Tranexamic Acid
Objective: Reduce bleeding by stabilizing blood clots.
Administration:
• Given intravenously, it is crucial to administer as soon as
PPH is diagnosed
• Administer slowly over 10 minutes
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13. IV

• Intravenous Fluids
Objective: Maintain blood volume and prevent shock.
Administration: Rapid infusion of IV fluids to stabilize
the patient.
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14. E

• Examination and Escalation
Objective: Identify and manage any remaining causes of
bleeding.
Procedure: Thorough examination of the genital tract for
trauma, retained tissue, or other issues, with escalation to
surgical interventions if needed.
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15. WHO PPH CARE BUNDLES

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16. Implementing E-MOTIVE in Clinical Practice

• Training and Education for all health workers
• Teamwork and Communication
• Protocol Adherence
• Monitoring and Evaluation
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17. Individual insight…

“This
new approach to treating postpartum
haemorrhage could radically improve women’s chances
of surviving childbirth globally, helping them get the
treatment they need when they need it,” said Professor
Arri Coomarasamy, who led the trial and is the CoDirector of the WHO Collaborating Centre on Global
Women’s Health at the University of Birmingham.
10/8/2025
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