title: Use of the non-pneumatic anti-shock garment (NASG) to reduce blood loss and time to recovery from shock for women with obstetric haemorrhage in Egypt.
abstract: Obstetric haemorrhage is one of the leading causes of maternal mortality. In many low-resource settings, delays in transport to referral facilities and in obtaining lifesaving treatment, contribute to maternal deaths. The non-pneumatic anti-shock garment (NASG) is a low-technology pressure device that decreases blood loss, restores vital signs, and has the potential to improve adverse outcomes by helping women survive delays in receiving adequate emergency obstetric care. With brief training, even individuals without medical backgrounds can apply this first-aid device. In this secondary analysis of hospital data from a pre-post intervention study in Egypt (N=364 women with obstetric haemorrhage and shock), 158 received standard care, while 206 received standard care plus the NASG. The NASG significantly reduced blood loss, time to recovery from shock, and, for those with postpartum haemorrhage due to uterine atony who received oxytocin, the NASG had a significant effect on blood loss independent of oxytocin. These results indicate that the NASG may be a valuable innovation for reducing maternal mortality in low-resource settings. Testing at community and household levels will be necessary in order to determine whether the NASG can help women survive the longest delays.
authors.affiliation: Women's Global Health Imperative, University of California, San Francisco, CA, USA. svellenmiller@hotmail.com
authors.forename: S
authors.initials: S
authors.lastname: Miller
authors.forename: J M
authors.initials: JM
authors.lastname: Turan
authors.forename: K
authors.initials: K
authors.lastname: Dau
authors.forename: M
authors.initials: M
authors.lastname: Fathalla
authors.forename: M
authors.initials: M
authors.lastname: Mourad
authors.forename: T
authors.initials: T
authors.lastname: Sutherland
authors.forename: S
authors.initials: S
authors.lastname: Hamza
authors.forename: F
authors.initials: F
authors.lastname: Lester
authors.forename: E B
authors.initials: EB
authors.lastname: Gibson
authors.forename: R
authors.initials: R
authors.lastname: Gipson
authors.forename: K
authors.initials: K
authors.lastname: Nada
authors.forename: P
authors.initials: P
authors.lastname: Hensleigh
mesh_terms: D004534:Egypt; D004867:Equipment Design; D005260:Female; D005392:First Aid / Q000295:instrumentation* / Q000379:methods; D005676:Gravity Suits; D006470:Hemorrhage / Q000628:therapy*; D006801:Humans; D008428:Maternal Mortality; D009774:Obstetrics; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D011256:Pregnancy Outcome; D012769:Shock / Q000534:rehabilitation*