title: A comparative study of the non-pneumatic anti-shock garment for the treatment of obstetric hemorrhage in Egypt.
abstract: OBJECTIVE
  To assess the impact of the non-pneumatic anti-shock garment (NASG) on maternal outcome following severe obstetric hemorrhage.
  
  
  METHODS
  A non-randomized pre-intervention/intervention study was conducted in 2 tertiary hospitals in Egypt from June 2006 to May 2008. Women with obstetric hemorrhage (estimated blood loss >or=1000 mL and/or >or=1 sign of shock [systolic blood pressure <100 mm Hg or pulse >100 beats per minute]) were treated with either a standardized protocol (pre-intervention) or a standardized protocol plus the NASG (intervention). The primary outcome was extreme adverse outcome (EAO), combining maternal mortality and severe morbidity (cardiac, respiratory, renal, or cerebral dysfunction). Secondary outcomes were measured blood loss, urine output, emergency hysterectomy, and (individually) mortality or morbidity. Analyses were performed to examine independent association of the NASG with EAO.
  
  
  RESULTS
  Mean measured blood loss decreased from 379 mL pre-intervention to 253 mL in the intervention group (P<0.01). In a multiple logistic regression model, the NASG was associated with reduced odds of EAO (odds ratio 0.38; 95% confidence interval, 0.17-0.85).
  
  
  CONCLUSIONS
  The NASG, in addition to standardized protocols at tertiary facilities for obstetric hemorrhage and shock, resulted in lower measured blood loss and reduced EAO.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA 94105, USA. suellenmiller@gmail.com
authors.forename: Suellen
authors.initials: S
authors.lastname: Miller
authors.forename: Mohamed M F
authors.initials: MM
authors.lastname: Fathalla
authors.forename: Mohammed M
authors.initials: MM
authors.lastname: Youssif
authors.forename: Janet
authors.initials: J
authors.lastname: Turan
authors.forename: Carol
authors.initials: C
authors.lastname: Camlin
authors.forename: Tarek K
authors.initials: TK
authors.lastname: Al-Hussaini
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Butrick
authors.forename: Carinne
authors.initials: C
authors.lastname: Meyer
mesh_terms: D000328:Adult; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006801:Humans; D006473:Postpartum Hemorrhage / Q000401:mortality / Q000628:therapy*; D011247:Pregnancy; D011481:Protective Clothing; D012769:Shock / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D055815:Young Adult