The Role of the Nonpneumatic Antishock Garment in Reducing Blood Loss and Mortality Associated with Post-Abortion Hemorrhage.
Maternal mortality attributable to post-abortion hemorrhage is often associated with delays in reaching or receiving definitive care. The nonpneumatic antishock garment (NASG), a low-technology first-aid device, has been shown to decrease blood loss and mortality among women experiencing hypovolemic shock secondary to obstetric hemorrhage etiologies. Women experiencing post-abortion hemorrhage face longer delays in receiving definitive treatment as a result of abortion-related stigma and lack of access to quality abortion care; thus the NASG has the potential to make an even greater impact within this population. We conducted a secondary analysis of data collected in Egypt, Nigeria, Zambia, and Zimbabwe in NASG trials, limiting our analytic sample to women who experienced post-abortion hemorrhage (n = 953). Blood loss significantly decreased when the NASG was added to standard hemorrhage management during the intervention phase, and there was a large, although not statistically significant, 52 percent decrease in mortality during the NASG phase. The results indicate that adding the NASG to post-abortion care among women experiencing severe hemorrhage and hypovolemic shock would decrease blood loss and mortality.
Resident Physician at Kaiser Permanente Los Angeles Medical Center, California.
Shila
S
Manandhar
Assistant Research Scientist, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of California, San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA 94158. alison.elayadi@ucsf.edu.
Alison M
AM
El Ayadi
Project Coordinator, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of California, San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA 94158.
Elizabeth
E
Butrick
Professor, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of California, San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA 94158.
Robert
R
Hosang
Lecturer, School of Public Health, University of California, Berkeley.
Suellen
S
Miller
D000028:Abortion, Induced / Q000009:adverse effects*; D000328:Adult; D058128:Compression Bandages; D004534:Egypt; D005260:Female; D005392:First Aid / Q000379:methods / Q000592:standards; D006801:Humans; D009026:Mortality; D009549:Nigeria; D019106:Postoperative Hemorrhage / Q000150:complications / Q000503:physiopathology; D011247:Pregnancy; D012720:Severity of Illness Index; D012769:Shock / Q000209:etiology / Q000401:mortality; D016896:Treatment Outcome; D015024:Zambia; D015030:Zimbabwe