Bleeding after childbirth (postpartum haemorrhage, PPH) is a common and potentially serious problem affecting 1 in 20 women.
Trials of PPH are very difficult to carry out because it is hard to predict and represent a clinical emergency when it occurs. As a result, guidance on PPH treatment comes largely from studies of drugs for PPH prevention and expert opinion. UK and international health organisations have therefore called for studies to see which drug is the most effective for initial PPH treatment.
The COPE study will compare two common treatments - oxytocin and carboprost. Oxytocin is routinely used as first option. Carboprost (a prostaglandin) contracts the uterus through a different mechanism to oxytocin. There is evidence that it is more effective than oxytocin, but it is usually reserved for second/third line therapy.