Abdominopelvic Compression for Obstetric Hemorrhage in Resource-Limited Locations [04C]. (May 2020)

• Record Type: Journal Article
• Authors: Kerr, Nancy L.; Hauswald, Mark; Tamrakar, Suman R.
• Is Part Of: Obstetrics and gynecology. Volume 135(2020)Supplement 1
• Publication Date: 2020-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000663248.07167.15
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: This quality improvement project evaluated obstetric hemorrhage patient outcomes following adoption of low cost simple pneumatic circumferential abdominopelvic compression devices. METHODS: Two resource-limited locations added low cost inflatable compression devices to their standard protocols for obstetric hemorrhage. Providers in small medical facilities in rural Nepal and Papua New Guinea used devices that incorporated either a bicycle tube or soccer ball to provide abdominopelvic pressure after all available routine treatments had failed. Data collected included obstetric event, etiology of bleeding, need for surgery, transfusion, transport, length of transports, maternal survival and complications. RESULTS: The device was used a total of 106 times: the soccer ball "Ball and Binder" device was used thirty-eight times; the prototype bicycle tube device was used sixty-eight times. Devices were used primarily after vaginal birth with atony, but also for obstetrical lacerations, miscarriages and post-abortion bleeding. In all cases the bleeding stopped promptly after inflation of the device. All 106 women survived, none required hysterectomy or abdominal surgery, and no complications were reported from device use. Only fifteen patients were transported to a referral hospital, primarily for blood transfusion. CONCLUSION: Obstetric hemorrhage was controlled after an abdominopelvic circumferential pressure device was applied after usual care had failed. This device provided an additional method for treatment in resource-limited settings with limitations in surgical, transfusion and transport capability.