Low-tech garment holds promise in preventing maternal death related to childbirthA simple, low-tech garment has the potential to prevent a major cause of death among women who give birth in many Third World countries, according to a new study by maternal health researchers.
Study findings show the use of a neoprene suit can save the lives of women suffering from obstetrical hemorrhaging due to childbirth. Hemorrhaging accounts for about 30 percent of the more than 500,000 maternal deaths worldwide each year due to childbirth, nearly all in poor countries, according to the researchers.
Results from a pilot study on the use of the suit, conducted at selected sites in Egypt, appear in today's online edition of the British Journal of Obstetrics and Gynecology. The findings will be published in the April issue of the journal.
Suellen Miller, CNM, PhD, who is an international maternal health expert and director of the Safe Motherhood Programs of the UCSF Women's Global Health Imperative, directed the pilot study, which evaluated use of a non-pneumatic anti-shock garment, or NASG.
The NASG is a simple, lightweight reusable neoprene suit – similar to the bottom half of a wetsuit. It is made up of five segments that close tightly with Velcro. Crucial compression is achieved by combining the three-way stretch of the neoprene and the tight Velcro closures.
When in shock, the brain, heart and lungs are deprived of oxygen because blood accumulates in the lower abdomen and legs. The compression from the NASG shunts blood from the lower extremities and abdominal area to the essential core organs: heart, lungs and brain. Within minutes of application, a hemorrhaging woman can regain consciousness and vital signs will normalize, according to Miller.
In the pilot study, 158 obstetrical hemorrhage patients underwent standard hemorrhage treatment and 206 patients with obstetrical hemorrhaging underwent standard treatment plus the NASG.
Study results showed a 50 percent decrease in blood loss among women treated with the NASG, which is statistically significant, according to Miller. Findings showed a 69 percent decrease in death and severe illness.
"These results are dramatic, particularly given that the NASG can be easily applied by anyone. No medical training is necessary," said Miller.
In developing countries, the majority of women give birth at home with poorly trained or untrained attendants, Miller explained. This suit is intended to keep a woman alive for several hours until she can be transported to a hospital where she can receive blood products and definitive treatment, such as surgery, in an effort to save her life.
"In our research, women who appeared clinically dead, with no blood pressure and no palpable pulse, were resuscitated and kept alive for up to two days while waiting for blood transfusions," said Miller.
In the United States, the suit had been used most recently by emergency medical technicians during transport of patients with lower body trauma to help prevent severe obstetrical hemorrhage by reversing shock and decreasing bleeding.
"Even though there have been variations of this suit used in the past, we see this as being somewhat revolutionary," said Miller. "We have demonstrated its efficacy in a limited way with the Egypt pilot study and will continue now with larger, more rigorous studies."
Participants from the study from UCSF in Egypt were Felicia Lester, ob/gyn resident; Kim Q. Dau, School of Nursing student; and Janet M. Turan, Traineeship in Aids Prevention Studies fellow.
The pilot study was supported by the John D. and Catherine T. MacArthur Foundation, which today announced an additional $1.15 million to fund additional research using the NASG in Egypt and Nigeria.
UCSF is a leading university that consistently defines health care worldwide by conducting advanced biomedical research, educating graduate students in the life sciences, and providing complex patient care.
The study appears online at http://www.blackwell-synergy.com/loi/bjo?open=2006
For more information on the MacArthur Foundation, contact Andrew Solomon at (312) 917-0313 or [email protected].
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