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Published in: Reproductive Health 1/2017

Open Access 01-12-2017 | Research

Experience in the use of non-pneumatic anti-shock garment (NASG) in the management of postpartum haemorrhage with hypovolemic shock in the Fundación Valle Del Lili, Cali, Colombia

Authors: María Fernanda Escobar, Carlos Eduardo Füchtner, Javier Andrés Carvajal, Albaro José Nieto, Adriana Messa, Sara Sofía Escobar, Angélica María Monroy, Angélica María Forero, José David Casallas, Marcela Granados, Suellen Miller

Published in: Reproductive Health | Issue 1/2017

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Abstract

Background

The aim of this case series is to describe the experience of using the non-pneumatic anti-shock garment (NASG) in the management of severe Postpartum hemorrhage (PPH) and shock, and the value of implementing this concept in high-complexity obstetric hospitals.

Methods

Descriptive case series of 77 women that received NASG in the management of PPH with severe hypovolemic shock from June 2014 to December 2015. Vital signs, shock index (SI), the lactic acid value and the base deficit were compared before and after NASG application.

Results

Fifty-six (77%) women had an SI > 1.1 at the time shock management was initiated; 96% had uterine atony. All women received standard does of uterotonics. The average time between the birth and NASG applications was 20 min. Forty-eight percent of women recovered haemodynamic variables in the first hour and 100% within the first 6 h; 100% had a SI < 1.0 in the first hour. The NASG was not removed until definitive control of bleeding was achieved, with an average time of use of 24 h. There were no mortalities.

Conclusions

In this case series of women in severe shock, the NASG was an effective management device for the control of severe hypovolemic shock. It should be considered a first-line option for shock management.
Literature
1.
go back to reference Alkema L, Chou D, Hogan D, Zhang S, Moller A, Allison G, Ma Fat D, Boerma T, Temmerman M, Mathers C, Say L. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. Lancet. 2015;387(10017):462–74.CrossRefPubMed Alkema L, Chou D, Hogan D, Zhang S, Moller A, Allison G, Ma Fat D, Boerma T, Temmerman M, Mathers C, Say L. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. Lancet. 2015;387(10017):462–74.CrossRefPubMed
2.
go back to reference Saad A, Constantine M. Obstetric hemorrhage: recent advances. Clin Obstet Gynecol. 2014;57(4):791–6.CrossRefPubMed Saad A, Constantine M. Obstetric hemorrhage: recent advances. Clin Obstet Gynecol. 2014;57(4):791–6.CrossRefPubMed
3.
go back to reference Rocha F, Costa ML, Cecatti JG, Parpinelli MA, Haddad SM, Pacaqnella RC, Sousa MH, Melo EF, Surita FG, Souza JP, et al. Severe maternal morbidity and near miss due to postpartum hemorrhage in a national multicenter surveillance study. Int J Gynaecol Obstet. 2014;128(2):131–6.CrossRef Rocha F, Costa ML, Cecatti JG, Parpinelli MA, Haddad SM, Pacaqnella RC, Sousa MH, Melo EF, Surita FG, Souza JP, et al. Severe maternal morbidity and near miss due to postpartum hemorrhage in a national multicenter surveillance study. Int J Gynaecol Obstet. 2014;128(2):131–6.CrossRef
4.
go back to reference Departamento Nacional de Planeación, Gobierno Colombiano, Informe de Seguimiento de los Objetivos de Desarrollo del Milenio, First Edition, published 2014. Departamento Nacional de Planeación, Gobierno Colombiano, Informe de Seguimiento de los Objetivos de Desarrollo del Milenio, First Edition, published 2014.
5.
go back to reference Dirección de vigilancia y análisis del riesgo en salud pública. Boletín epidemiológico semanal. Instituto nacional de salud de Colombia. 2015; (1): 1–72. Dirección de vigilancia y análisis del riesgo en salud pública. Boletín epidemiológico semanal. Instituto nacional de salud de Colombia. 2015; (1): 1–72.
6.
go back to reference Resultados de la implementación del sistema de vigilancia de la mortalidad materna basada en la Web, Colombia, 2015. Bogotá: OPS.2016. Resultados de la implementación del sistema de vigilancia de la mortalidad materna basada en la Web, Colombia, 2015. Bogotá: OPS.2016.
7.
go back to reference Homer C, Clements V, McDonnell N, Peek M, Sullivan E. Maternal mortality: what can we learn from stories of postpartum haemorrhage? Women Birth. 2009;22(3):97–104.CrossRefPubMed Homer C, Clements V, McDonnell N, Peek M, Sullivan E. Maternal mortality: what can we learn from stories of postpartum haemorrhage? Women Birth. 2009;22(3):97–104.CrossRefPubMed
8.
go back to reference Carroli G, Cuesta C, Abalos E, Gulmezoglu AM. Epidemiology of postpartum haemorrhage: a systematic review. Best Pract Res Clin Obstet Gynaecol. 2008;22(6):999–1012.CrossRefPubMed Carroli G, Cuesta C, Abalos E, Gulmezoglu AM. Epidemiology of postpartum haemorrhage: a systematic review. Best Pract Res Clin Obstet Gynaecol. 2008;22(6):999–1012.CrossRefPubMed
9.
go back to reference Stenson AL, Miller S, Lester F. The mechanisms of action of the non-pneumatic anti-shock garment. Arulkumaran SS Karoshi M Keith LG Lalonde AB B-Lynch C Ed Compr Textb Postpartum Hemorrhage 2nd Ed USA Sapiens Publ. 2012;331–40. Stenson AL, Miller S, Lester F. The mechanisms of action of the non-pneumatic anti-shock garment. Arulkumaran SS Karoshi M Keith LG Lalonde AB B-Lynch C Ed Compr Textb Postpartum Hemorrhage 2nd Ed USA Sapiens Publ. 2012;331–40.
10.
go back to reference Miller S, Hamza S, Bray E, Lester F, Nada K, Gibson R, et al. First aid for obstetric haemorrhage: the pilot study of the non-pneumatic anti-shock garment in Egypt. BJOG. 2006;113(4):424–9.CrossRefPubMed Miller S, Hamza S, Bray E, Lester F, Nada K, Gibson R, et al. First aid for obstetric haemorrhage: the pilot study of the non-pneumatic anti-shock garment in Egypt. BJOG. 2006;113(4):424–9.CrossRefPubMed
11.
go back to reference Miller S, Fathalla M, Youssif M, Turan J, Camlin C, Al-Hussaini TK, Butrick E, Meyer C. A comparative study of the non-pneumatic anti-shock garment for the treatment of obstetric hemor- rhage in Egypt. Int J Gynecol Obstet. 2010;109(1):20–4.CrossRef Miller S, Fathalla M, Youssif M, Turan J, Camlin C, Al-Hussaini TK, Butrick E, Meyer C. A comparative study of the non-pneumatic anti-shock garment for the treatment of obstetric hemor- rhage in Egypt. Int J Gynecol Obstet. 2010;109(1):20–4.CrossRef
12.
go back to reference Miller S, Fathalla MM, Ojengbede OA, Camlin C, Mourad-Youssif M, Morhason-Bello IO, et al. Obstetric hemorrhage and shock management: using the low technology non-pneumatic anti-shock garment in Nigerian and Egyptian tertiary care facilities. BMC Pregnancy Childbirth. 2010;10:64.CrossRefPubMedPubMedCentral Miller S, Fathalla MM, Ojengbede OA, Camlin C, Mourad-Youssif M, Morhason-Bello IO, et al. Obstetric hemorrhage and shock management: using the low technology non-pneumatic anti-shock garment in Nigerian and Egyptian tertiary care facilities. BMC Pregnancy Childbirth. 2010;10:64.CrossRefPubMedPubMedCentral
13.
go back to reference Maknikar S, Nanda R, Miller S. NASG reduces mortality in Indian women with PPH. O429. Int J Gynecol Obstet. 2012;119 Suppl 3:S413.CrossRef Maknikar S, Nanda R, Miller S. NASG reduces mortality in Indian women with PPH. O429. Int J Gynecol Obstet. 2012;119 Suppl 3:S413.CrossRef
14.
go back to reference Magwali TL, Butrick E, Mambo V, El Ayadi A, Lippman S, Bergel L, et al. Non-pneumatic anti-shock garment (NASG) for obstetric hemorrhage: Harare, Zimbabwe. O421. Int J Gynecol Obstet. 2012;119 Suppl 3:S410.CrossRef Magwali TL, Butrick E, Mambo V, El Ayadi A, Lippman S, Bergel L, et al. Non-pneumatic anti-shock garment (NASG) for obstetric hemorrhage: Harare, Zimbabwe. O421. Int J Gynecol Obstet. 2012;119 Suppl 3:S410.CrossRef
15.
go back to reference El Ayadi AM, Butrick E, Geissler J, Miller S. Combined analysis of the non-pneumatic anti-shock garment on mortality from hypovolemic shock secondary to obstetric hemorrhage. BMC Pregnancy Childbirth. 2013;13:208.CrossRefPubMedPubMedCentral El Ayadi AM, Butrick E, Geissler J, Miller S. Combined analysis of the non-pneumatic anti-shock garment on mortality from hypovolemic shock secondary to obstetric hemorrhage. BMC Pregnancy Childbirth. 2013;13:208.CrossRefPubMedPubMedCentral
16.
go back to reference Miller S, Bergel EF, El Ayadi A, Gibbons L, Butrick EA, Magwali T, et al. Non-pneumatic anti-shock garment (NASG), a first-aid device to decrease maternal mortality from obstetric hemorrhage: a cluster randomized trial. PLoS One. 2013;8(10):e76477.CrossRefPubMedPubMedCentral Miller S, Bergel EF, El Ayadi A, Gibbons L, Butrick EA, Magwali T, et al. Non-pneumatic anti-shock garment (NASG), a first-aid device to decrease maternal mortality from obstetric hemorrhage: a cluster randomized trial. PLoS One. 2013;8(10):e76477.CrossRefPubMedPubMedCentral
17.
go back to reference World Health Organization. WHO recommendations for the prevention and treatment of postpartum haemorrhage. 1st Edition. Published 2012. World Health Organization. WHO recommendations for the prevention and treatment of postpartum haemorrhage. 1st Edition. Published 2012.
18.
go back to reference FIGO Safe Motherhood and Newborn Health Committee. Non-pneumatic anti-shock garment to stabilize women with hypovolemic shock secondary to obstetric hemorrhage. Int J Gynecol Obstet. 2015;128(3):194–5.CrossRef FIGO Safe Motherhood and Newborn Health Committee. Non-pneumatic anti-shock garment to stabilize women with hypovolemic shock secondary to obstetric hemorrhage. Int J Gynecol Obstet. 2015;128(3):194–5.CrossRef
20.
go back to reference Sohn CH, Kim WY, Kim SR, Seo DW, Ryoo SM, Lee YS, Lee JH, Oh BJ, Won HS, Shim JY, Lim KS. An increase in initial shock index is associated with the requirement for massive transfusion in emergency department patients with primary postpartum hemorrhage. Shock. 2013;40(2):101–5.CrossRefPubMed Sohn CH, Kim WY, Kim SR, Seo DW, Ryoo SM, Lee YS, Lee JH, Oh BJ, Won HS, Shim JY, Lim KS. An increase in initial shock index is associated with the requirement for massive transfusion in emergency department patients with primary postpartum hemorrhage. Shock. 2013;40(2):101–5.CrossRefPubMed
21.
go back to reference Pacagnella RC, Souza JP, Durocher J, Perel P, Blum J, et al. A systematic review of the relationship between blood loss and clinical signs. PLoS ONE. 2013;8(3), e57594.CrossRefPubMedPubMedCentral Pacagnella RC, Souza JP, Durocher J, Perel P, Blum J, et al. A systematic review of the relationship between blood loss and clinical signs. PLoS ONE. 2013;8(3), e57594.CrossRefPubMedPubMedCentral
22.
go back to reference Le Bas A, Chandraharan E, Addei A, Arulkumaran S. Use of the “obstetric shock index” as an adjunct in identifying significant blood loss in patients with massive postpartum hemorrhage. Int J Gynecol Obstet. 2014;124(3):253–5.CrossRef Le Bas A, Chandraharan E, Addei A, Arulkumaran S. Use of the “obstetric shock index” as an adjunct in identifying significant blood loss in patients with massive postpartum hemorrhage. Int J Gynecol Obstet. 2014;124(3):253–5.CrossRef
23.
24.
go back to reference Jelks A, Berletti M, Hamlett L, Hugin M. Nonpneumatic antishock garment combined with bakri balloon as a non operative “uterine sandwich” for temporization of massive postpartum hemorrhage from disseminated intravascular coagulation. Case Rep Obstet Gynecol. 2015;2015:124157.PubMedPubMedCentral Jelks A, Berletti M, Hamlett L, Hugin M. Nonpneumatic antishock garment combined with bakri balloon as a non operative “uterine sandwich” for temporization of massive postpartum hemorrhage from disseminated intravascular coagulation. Case Rep Obstet Gynecol. 2015;2015:124157.PubMedPubMedCentral
25.
go back to reference Pileggi-Castro C, Nogueira-Pileggi V, Tunçalp Ö, Oladapo OT, Vogel JP, Souza JP. Non-pneumatic anti-shock garment for improving maternal survival following severe postpartum haemorrhage: a systematic review. Reprod Health. 2015;12:28.CrossRefPubMedPubMedCentral Pileggi-Castro C, Nogueira-Pileggi V, Tunçalp Ö, Oladapo OT, Vogel JP, Souza JP. Non-pneumatic anti-shock garment for improving maternal survival following severe postpartum haemorrhage: a systematic review. Reprod Health. 2015;12:28.CrossRefPubMedPubMedCentral
26.
go back to reference Nathan HL, El Ayadi A, Hezelgrave NL, Seed P, Butrick E, Miller S, Briley A, Bewley S, Shennan AH. Shock index: an effective predictor of outcome in postpartum haemorrhage? BJOG. 2015;122(2):268–75.CrossRefPubMed Nathan HL, El Ayadi A, Hezelgrave NL, Seed P, Butrick E, Miller S, Briley A, Bewley S, Shennan AH. Shock index: an effective predictor of outcome in postpartum haemorrhage? BJOG. 2015;122(2):268–75.CrossRefPubMed
Metadata
Title
Experience in the use of non-pneumatic anti-shock garment (NASG) in the management of postpartum haemorrhage with hypovolemic shock in the Fundación Valle Del Lili, Cali, Colombia
Authors
María Fernanda Escobar
Carlos Eduardo Füchtner
Javier Andrés Carvajal
Albaro José Nieto
Adriana Messa
Sara Sofía Escobar
Angélica María Monroy
Angélica María Forero
José David Casallas
Marcela Granados
Suellen Miller
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Reproductive Health / Issue 1/2017
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/s12978-017-0325-2

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