265828 A comparative study of the Non-Pneumatic Anti-Shock Garment (NASG) on women with obstetric hemorrhage At-Risk for Eclampsia (ARE)

Monday, October 29, 2012

Sarah Ismail, MPH , Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA
Sheri Lippman, PhD, MPH , Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA
Maureen Lahiff, PhD , School of Public Health, University of California, Berkeley, Berkeley, CA
Jessica Morris , Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA
Suellen Miller, PhD, CNM , Dept. Obstetrics, Gynecology & Reproductive Sciences, Bixby Center for Global Reproductive Health and Policy, University of California, San Francisco, San Francisco, CA
Objectives: To assess if using a first-aid device, the Non-pneumatic Anti-Shock Garment (NASG), is harmful or protective for women at risk for or experiencing eclampsia (ARE) who have hypovolemic shock secondary to obstetric hemorrhage. Methods: Two non-randomized pre-intervention / NASG intervention parent studies were conducted in Egypt and Nigeria between 2004 2008 with a total of 1,746 patients from 14 obstetric centers 2 in Egypt and 12 in Nigeria. Inclusion criteria were that a woman experienced obstetric/pregnancy-related hemorrhage blood loss of at least 750ml and at least one clinical sign of hypovolemic shock (BP<100mmHg and/or pulse>100 beats per minute). A woman was considered ARE if she was clinically diagnosed with eclampsia or fulfilled one of four recognized criteria. Outcomes measured were severe morbidity or mortality, combined as Extreme Adverse Maternal Outcome (EAO). Results: Of 133 ARE women, 58 women were in the pre-intervention phase (unexposed) and 75 in the intervention phase (exposed/NASG). The NASG was found to have a significant protective effect for EAO: aOR 0.26, CI 0.07-0.93, with women treated with the NASG having 0.26 reduced odds of experiencing an EAO as compared to women in the pre-NASG phase. In sensitivity analyses, results were more pronounced among women diagnosed clinically with eclampsia (aOR 0.23, CI 0.06 0.97). Conclusions: Results suggest that the NASG is safe to use on all women, including women at risk for and diagnosed with eclampsia. Further data from a randomized controlled cluster trial underway in Zambia and Zimbabwe will provide more insight.

Learning Areas:
Basic medical science applied in public health
Other professions or practice related to public health
Public health biology
Public health or related nursing
Public health or related research

Learning Objectives:
Describe the Non-Pneumatic Anti-Shock Garment Explain how the Non-Pneumatic Anti-Shock Garment works List criteria for a woman with obstetric hemorrhage List criteria for a woman at risk for eclampsia

Keywords: International MCH, International Reproductive Health

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Non-Pneumatic AntiShock Garment is a low-technology first-aid device used to treat hypovolemic shock. It's efficacy for reducing maternal deaths due to obstetrical hemorrhage is being researched.

Qualified on the content I am responsible for because: I am the primary person who has analyzed the data for this specific research. I have a Masters in Public Health in Maternal and Child Health from UC Berkeley and I have been working in the field of Maternal and Child Health for the past four years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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