273799 Non-pneumatic Anti-Shock Garment Reduces Maternal Mortality from Hypovolemic Shock Secondary to Obstetric Hemorrhage

Tuesday, October 30, 2012 : 9:30 AM - 9:45 AM

Suellen Miller, PhD, CNM , Dept. Obstetrics, Gynecology & Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA
Background: The Non-pneumatic Anti-Shock Garment (NASG), is a first-aid compression device that when wrapped around the lower limbs and abdomen of a woman with delays accessing care.

Methods: A quasi-experimental design was used to collect data on 2025 women with hypovolemic shock (n=1022 treated with standard protocol, n=1003 standard protocol plus NASG) in referral facilities in Egypt, Nigeria, India, Zambia and Zimbabwe. Outcomes included volume of measured blood lost and mortality. Differences were compared with t-test and chi square.

Results: There were no significant differences between groups, except that NASG users were in worse condition on study admission. Despite this, outcomes were improved with the NASG. Blood loss was significantly reduced over 50%; mortality decreased by 33%, from 5.7% without-NASG to 3.8% with NASG, (p=0.05)

Conclusions: In this combined analysis, the NASG, when added to standard obstetric hemorrhage protocol, significantly reduced blood loss and maternal mortality at referral facilities.

Learning Objectives:
1. Discuss and describe the composition of the Non-pneumatic Anti-Shock Garment and its mechanisms of action in reversing hypovolemic shock 2. Compare outcomes for women suffering severe hypovolemic shock secondary to obstetric hemorrhage treated with standard protocol and standard protocol plus NASG.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: With over 30 years’ experience as a midwife, I have conducted international reproductive health research in a variety of countries and am familiar with emergency obstetric and midwifery management. Since 2003 I have been the leading researcher on the NASG for obstetric hemorrhage, conducting a Randomized Cluster Trial in Zambia and Zimbabwe. I have conducted NASG trials in Egypt and Nigeria and lectured and trained clinicians on PPH and the NASG globally.
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.