The NASG, in addition to standardized protocols at tertiary facilities for obstetric hemorrhage and shock, resulted in lower measured blood loss and reduced EAO.
Objective: To determine whether the non-pneumatic anti-shock garment (NASG) reduces maternal morbidity and mortality from uterine atony. Method: Women with uterine atony (blood loss of ≥1000 ml) and one clinical sign of shock were enrolled in a pre-intervention phase (n=169) and an intervention phase (n=269) at two referral facilities in Egypt. Differences in demographics, condition on study entry, treatment, and outcomes were examined. Relative risks and 95% confidence intervals (CI) were estimated for mean measured blood loss, emergency hysterectomy, and extreme adverse outcomes (EAO)—a combination of morbidity and mortality. Results: in the intervention phase, mean measured blood loss was significantly reduced, emergency hysterectomy was significantly decreased, and there were fewer EAOs (11% to 3% in the NASG phase, relative risk=0.28, 95% CI: 0.12–0.63). A subgroup analysis of only women in severe shock demonstrated similar trends. Conclusion: The NASG shows promise for reducing blood loss, emergency hysterectomies, and EAO from obstetric haemorrhage-related shock due to uterine atony.
The study aims to determine if the nonpneumatic antishock garment (NASG), a first aid compression device, decreases severe adverse outcomes from nonatonic obstetric haemorrhage. Women with nonatonic aetiologies (434), blood loss > 1000 mL, and signs of shock were eligible. Women received standard care during the preintervention phase (226) and standard care plus application of the garment in the NASG phase (208). Blood loss and extreme adverse outcomes (EAO-mortality and severe morbidity) were measured. Women who used the NASG had more estimated blood loss on admission. Mean measured blood loss was 370 mL in the preintervention phase and 258 mL in the NASG phase (P < 0.0001). EAO decreased with use of the garment (2.9% versus 4.4%, (OR 0.65, 95% CI 0.24–1.76)). In conclusion, using the NASG improved maternal outcomes despite the worse condition on study entry. These findings should be tested in larger studies.
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