Non-pneumatic anti-shock garment (NASG) and balloon tamponade decrease maternal mortality and morbidity from Obstetrics Haemorrhage: A prospective observational study

Ashish Zarariya, Arya Chaubey, Dr D Harikanth
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Abstract

Obstetric haemorrhage is the leading cause of maternal mortality and morbidity worldwide. A prospective observational study was conducted among 132 women admitted, booked/referred, at tertiary care centre with Obstetric Haemorrhage for 2 years period. Of these 71 patients had received Non-pneumatic antishock garment and / or Uterine Balloon Tamponade (Group 1) and 61 didn’t receive any (Group 2). Both groups were observed for its outcome. The socio-demographic parameters and obstetric characteristics among both groups were comparable. However, there were differences in their outcomes and complications. Surgical interventions were more among group 2 as compared to group 1, B-lynch/Modified B-lynch (8.4% vs. 1.6%), Stepwise devascularisation (2.8% vs. 1.6%) and Obstetric hysterectomy (7.0% vs. 3.2%). There was significantly more blood loss in Group 2 than group 1. Duration of hospital stay was significantly shorter (9.8±2.7 days) in Group 1 as compared to Group 2 (12.7±3.6). The shock index after intervention was significantly smaller (0.7±0.1) in Group 1 in comparison to Group 2 (0.8±0.1) and Group 1 required significantly less number of blood and blood products as compared to group 2. 19.7% required ICU admission in group 1 and 24.6% in Group 2. There was no mortality in group 1 and 3 patients died in group 2. NASG and UBT is both life-saving and cost effective and can become the first defence against Obstetric Haemorrhage.
非充气防震衣(NASG)和气囊填塞可降低产科大出血的产妇死亡率和发病率:前瞻性观察研究
产科出血是全球孕产妇死亡和发病的主要原因。一项前瞻性观察研究针对 132 名因产科大出血在三级医疗中心住院、预约/转诊的产妇进行,为期两年。其中 71 名患者接受了非气动防震衣和/或子宫球囊填塞术(第 1 组),61 名患者未接受任何治疗(第 2 组)。两组患者均接受了疗效观察。两组的社会人口学参数和产科特征具有可比性。但是,两组的结果和并发症存在差异。与第一组相比,第二组的手术干预更多,包括 B-lynch/改良 B-lynch(8.4% 对 1.6%)、逐步血管切除术(2.8% 对 1.6%)和产科子宫切除术(7.0% 对 3.2%)。第一组的住院时间(9.8±2.7 天)明显短于第二组(12.7±3.6 天)。第 1 组干预后的休克指数(0.7±0.1)明显小于第 2 组(0.8±0.1),第 1 组所需血液和血制品的数量明显少于第 2 组。
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