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. 2024 Nov 7;9(11):e015342. doi: 10.1136/bmjgh-2024-015342

Table 3. Final top priority research questions by track, ordered from highest to lowest priority.

Rank Innovation Implementation Cross-cutting
1 What is the comparative effectiveness and safety of alternative routes of tranexamic acid (TXA) in the treatment of PPH? What are the implementation barriers and facilitators affecting the adoption and use of evidence-based recommendations for PPH management? What is the effectiveness of a strategy of early detection and first response treatment using a bundle of recommended interventions for improving PPH-related outcomes?
2 What is the effectiveness and safety of heat-stable carbetocin for PPH treatment in women who received heat-stable carbetocin for PPH prevention? What are the optimal strategies to ensure access to quality-assured PPH medicines (including universal health coverage/essential packages for health services and health benefit package) in low-income and middle-income countries? What is the effectiveness and safety of a diagnostic algorithm (eg, Shock Index) and early detection strategies (eg, Modified Early Obstetric Warning Score) in improving clinical detection and management of PPH?
3 What is the comparative effectiveness of uterine balloon tamponade devices compared with other tamponade interventions (such as suction devices) in the reduction of PPH-related maternal morbidity and mortality? What are the most effective advocacy strategies to improve the uptake and ensure sustainment of evidence-based practices for PPH management at the country level? What is the effectiveness of checklists in improving PPH quality of care and PPH-related outcomes compared with current standard of care?
4 Can clinical criteria for haemodynamic instability facilitate earlier PPH diagnosis and improved PPH outcomes compared with blood loss measurement alone? What is the effectiveness and cost of pre-service and in-service training programmes for front-line healthcare workers (paramedics, general practice doctors, community health workers, midwives, nurses) to manage and refer women with PPH? What is the effectiveness of Maternal and Perinatal Death Surveillance and Response programmes in the reduction of maternal deaths due to PPH?
5 What strategies are most effective for engaging the private sector in the development of new PPH medicines, devices and diagnostics in low-income and middle-income countries? What are the most effective implementation strategies to improve uptake and sustainment of recommended evidence-based interventions for PPH management, including in humanitarian settings? What is the effectiveness and safety of TXA in the prevention of PPH in general obstetric population and in women at high risk of PPH (eg, anaemic women)?

PPHpostpartum haemorrhage