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Reprod Health. 2015 Mar 31;12:28. doi: 10.1186/s12978-015-0012-0.

Non-pneumatic anti-shock garment for improving maternal survival following severe postpartum haemorrhage: a systematic review.

Author information

1
Department of Pediatrics & Glide Technical Cooperation and Research, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil. cynthiapileggi@gmail.com.
2
Department of Pediatrics & Glide Technical Cooperation and Research, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil. vicky.pileggi@gmail.com.
3
UNDP-UNFPA-UNICEF-WHO World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Reproductive Health and Research, WHO, Geneva, Switzerland. tuncalpo@who.int.
4
UNDP-UNFPA-UNICEF-WHO World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Reproductive Health and Research, WHO, Geneva, Switzerland. oladapoo@who.int.
5
UNDP-UNFPA-UNICEF-WHO World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Reproductive Health and Research, WHO, Geneva, Switzerland. vogeljo@who.int.
6
Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Ribeirão Preto, SP, Brazil. jpsouza@fmrp.usp.br.

Abstract

INTRODUCTION:

Women with postpartum haemorrhage (PPH) in developing countries often present in critical condition when treatment might be insufficient to save lives. Few studies have shown that application of non-pneumatic anti-shock garment (NASG) could improve maternal survival.

METHODS:

A systematic review of the literature explored the effect of NASG use compared with standard care for treating PPH. Medline, EMBASE and PubMed were searched. Methodological quality was assessed following the criteria suggested by the Cochrane Effective Practice and Organization of Care Group. Guidelines on Meta-analysis of Observational Studies in Epidemiology were used for reporting the results. Mantel-Haenszel methods for meta-analysis of risk ratios were used.

RESULTS:

Six out 31 studies met the inclusion criteria; only one cluster randomized controlled trial (c-RCT). Among observational studies, NASG fared better than standard care regarding maternal mortality reduction (Relative Risk (RR) 0.52 (95% Confidence interval (CI) 0.36 to 0.77)). A non-significant reduction of maternal mortality risk was observed in the c-RCT (RR: 0.43 (95% CI: 0.14 to 1.33)). No difference was observed between NASG use and standard care on use of blood products. Severe maternal outcomes were used as proxy for maternal death with similar pattern corroborating the trend towards beneficial effects associated with NASG.

CONCLUSION:

NASG is a temporizing alternative measure in PPH management that shows a trend to reduce PPH-related deaths and severe morbidities. In settings where delays in PPH management are common, particularly where constraints to offer blood products and definitive treatment exist, use of NASG is an intervention that should be considered as a policy option while the standard conditions for care are being optimized.

PMID:
25889868
PMCID:
PMC4422609
DOI:
10.1186/s12978-015-0012-0
[Indexed for MEDLINE]
Free PMC Article

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