A comparative study of the non-pneumatic anti-shock garment for the treatment of obstetric hemorrhage in Egypt

Miller, Suellen; Fathalla, Mohamed M.F.; Youssif, Mohammed M.; Turan, Janet; Camlin, Carol; Al-Hussaini, Tarek K.; Butrick, Elizabeth; Meyer, Carinne

doi:10.1016/j.ijgo.2009.11.016

« Previous Next »International Journal of Gynecology & Obstetrics
Volume 109, Issue 1 , Pages 20-24, April 2010

A comparative study of the non-pneumatic anti-shock garment for the treatment of obstetric hemorrhage in Egypt

Suellen Miller
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, USA
- Corresponding author. 50 Beale Street, Suite 1200, San Francisco, CA 94105, USA. Tel.: +1 415 597 9394.
Mohamed M.F. Fathalla
- Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University Women's Health Center, Assiut, Egypt
Mohammed M. Youssif
- Department of Obstetrics and Gynecology, El Galaa Maternity Teaching Hospital, Cairo, Egypt
Janet Turan
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, USA
Carol Camlin
- Center for AIDS Prevention Studies, University of California, San Francisco, USA
Tarek K. Al-Hussaini
- Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University Women's Health Center, Assiut, Egypt
Elizabeth Butrick
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, USA
Carinne Meyer
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, USA

Received 23 September 2009; received in revised form 4 November 2009; accepted 10 December 2009. published online 25 January 2010.

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 ≥1000mL and/or ≥1 sign of shock [systolic blood pressure <100mm 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 379mL pre-intervention to 253mL 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).

Conclusion

The NASG, in addition to standardized protocols at tertiary facilities for obstetric hemorrhage and shock, resulted in lower measured blood loss and reduced EAO.

Keywords: Anti-shock garment, Emergency obstetric care, Maternal morbidity, Maternal mortality, Obstetric hemorrhage