British experts have issued a warning about a drug in wide use in poor countries to save the lives of critically ill women after pregnancy.
The drug misoprostol was developed for gastric ulcers but is now used in many countries to try to treat bleeding after pregnancy.
However a review published today says there is no evidence for its effectiveness.
Researchers led by Professor Allyson Pollock, of Queen Mary, University of London, report their findings in the Journal of the Royal Society of Medicine.
They found 172 studies of the use of the drug during labour – but found only six with enough information to establish the benefits of the drug in rural and community settings in low income countries.
Their conclusion is that the studies do not provide evidence to back use of the drug.
Professor Pollock called on the World Health Organisation to rethink its support for the drug.
She said: "Despite there being no proper evidence of benefit, the WHO and some countries have put it on the Essential Medicine Lists and the drug is being pushed hard by networks of global public-private partnerships and industry in low- and middle-income countries. Countries such as Nepal, India and Uganda are promoting and using it."
Professor Pollock says the most effective way to prevent bleeding is to screen women for anaemia.
She said: "Countries should be concentrating on improving their primary care facilities, rather than thinking there is a pill to prevent every ill.
"Misoprostol is being used inappropriately at present, and the money being spent on purchasing the drug would be better spent elsewhere, for instance, in ensuring there are skilled attendants during delivery and adequate antenatal services that can detect and help to prevent complications.
"Developed countries would not dream of giving women misoprostol during labour on the basis of the current evidence, yet industry and health practitioners are pushing it hard in developing countries."
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