NASG and balloon tamponade improve outcomes in obstetrics hemorrhage cases

Obstetric hemorrhage stands as the primary contributor to maternal mortality and morbidity globally. 

The goal of aprospective observational study was to investigate this issue. This study was conducted over twoyears and involved 132 women admitted to a tertiary care center with obstetric hemorrhage. Among them, 71 patients received treatment with Non-pneumatic Antishock Garment (NASG) and/or Uterine Balloon Tamponade (UBT) (Group 1), while 61 did not receive any such interventions (Group 2). The outcomes were observed and compared.

The results showed that the socio-demographic parameters and obstetric characteristics were identical between the two groups. Nevertheless, disparities in outcomes and complications were evident. Group 2 witnessed a higher incidence of surgical interventions, including B-lynch/Modified B-lynch (8.4% vs. 1.6%), Stepwise devascularization (2.8% vs. 1.6%), and Obstetric hysterectomy (7.0% vs. 3.2%). Group 2 also experienced significantly greater blood loss. The hospital stay duration was notably shorter (9.8±2.7 days) in Group 1 compared to Group 2 (12.7±3.6). Post-intervention, Group 1 exhibited a significantly smaller shock index (0.7±0.1) than Group 2 (0.8±0.1)––requiring a significantly lower quantity of blood and blood products. ICU admission rates were 19.7% in Group 1 and 24.6% in Group 2, with no mortality reported in Group 1 and three deaths in Group 2.

It was inferred that utilizing NASG and UBT proves to be life-saving and cost-effective – serving as a crucial first line of defense against obstetric hemorrhage. These techniques, which can be implemented in limited-resource centers with minimal training, are not only effective but also contribute to preserving fertility and avoiding more invasive procedures such as laparotomy.

Source: Zarariya A, Chaubey A, Harikanth DR. Indian J ObstetGynecol Res. 2023;10(4):433-438