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Escobar MF, Füchtner CE, Carvajal JA, Nieto AJ, Messa A, Escobar SS, Monroy AM, Forero AM, Casallas JD, Granados M, Miller S. Experience in the use of non-pneumatic anti-shock garment (NASG) in the management of postpartum haemorrhage with hypovolemic shock in the Fundación Valle Del Lili, Cali, Colombia. Reprod Health 2017; 14:58. [PMID: 28499381 PMCID: PMC5427550 DOI: 10.1186/s12978-017-0325-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 05/03/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this case series is to describe the experience of using the non-pneumatic anti-shock garment (NASG) in the management of severe Postpartum hemorrhage (PPH) and shock, and the value of implementing this concept in high-complexity obstetric hospitals. METHODS Descriptive case series of 77 women that received NASG in the management of PPH with severe hypovolemic shock from June 2014 to December 2015. Vital signs, shock index (SI), the lactic acid value and the base deficit were compared before and after NASG application. RESULTS Fifty-six (77%) women had an SI > 1.1 at the time shock management was initiated; 96% had uterine atony. All women received standard does of uterotonics. The average time between the birth and NASG applications was 20 min. Forty-eight percent of women recovered haemodynamic variables in the first hour and 100% within the first 6 h; 100% had a SI < 1.0 in the first hour. The NASG was not removed until definitive control of bleeding was achieved, with an average time of use of 24 h. There were no mortalities. CONCLUSIONS In this case series of women in severe shock, the NASG was an effective management device for the control of severe hypovolemic shock. It should be considered a first-line option for shock management.
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Affiliation(s)
- María Fernanda Escobar
- Department of Gynecology and Obstetrics, Fundación Clínica Valle del Lili, Universidad ICESI, Cali, Colombia.
| | | | - Javier Andrés Carvajal
- Department of Gynecology and Obstetrics, Fellow of Intensive Care Unit, Fundación Clínica Valle del Lili, Cali, Colombia
| | - Albaro José Nieto
- Department of Gynecology and Obstetrics, Fundación Clínica Valle del Lili, Universidad ICESI, Cali, Colombia
| | - Adriana Messa
- Department of Gynecology and Obstetrics, Fundación Clínica Valle del Lili, Universidad ICESI, Cali, Colombia
| | - Sara Sofía Escobar
- Department of Health Sciences, Medicine School, Universidad ICESI, Fundación Clínica Valle del Lili, Cali, Colombia
| | - Angélica María Monroy
- Department of Health Sciences, Medicine School, Universidad ICESI, Fundación Clínica Valle del Lili, Cali, Colombia
| | - Angélica María Forero
- Clinical Investigation Centre, Department of Gynecology and Obstetrics, Fundación Clínica Valle del Lili, Cali, Colombia
| | - José David Casallas
- Clinical Investigation Centre, Department of Gynecology and Obstetrics, Fundación Clínica Valle del Lili, Cali, Colombia
| | - Marcela Granados
- Internal Medicine, Intensive Care Unit, Fundación Clínica Valle del Lili, Cali, Colombia
| | - Suellen Miller
- Safe Motherhood Programs, Department of Obstetrics, Gynecology & reproductive Sciences, Bixby Center for Global Reproductive Health and Policy School of Medicine, University of California, San Francisco (UCSF), San Francisco, USA
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