Prevention and Management of PPH with Uterotonics and NASG
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Prevention and Management of PPH with Uterotonics and NASG
- 1. Prevention and Management of PPH: Utilizing Uterotonics and the Non-Pneumatic Anti-Shock Garment (NASG) Dr. Abdelhadi Eltahir, Sr. Advisor for Maternal and Newborn Health CORE Group Spring Meeting EQUITY IN HEALTH: ENSURING ACCESS, INCREASING USE Radisson Hotel, Baltimore May 9 to 13, 2011
- 4. Expanding clinical staff capacity to improve quality of services
- 7. Induce or augment labor by;
- 8. Increasing frequency of contractions during labor,
- 9. Increasing intensity of contractions during labor, and
- 12. MisoprostolInjectable uterotonic drugs are administered IM or IV Tablet uterotonics are given orally, vaginally or rectally (for PPH)
- 13. Retaining effectiveness and potency UTEROTONICS SHOCK & NASG OUR WORK OVERVIEW Source: WHO, USAID, POPPHI
- 14. UTEROTONICS SHOCK & NASG OUR WORK OVERVIEW Shift to best practice in use of uterotonics: Oxytocin Oxytocin is the drug of choice for AMTSL Administering oxytocin immediately after childbirth has led to significant impact in preventing and reducing PPH Demand remains high for AMTSL
- 15. UTEROTONICS SHOCK & NASG OUR WORK OVERVIEW Addressing Hypovolemic Shock: How the non-pneumatic anti-shock garment (NASG) works
- 16. UTEROTONICS SHOCK & NASG OUR WORK OVERVIEW The non-pneumatic anti-shock garment (NASG) The NASG shunts blood accumulating in the lower extremities back up to the vital organs, including the brain, heart, and lungs Women in shock are placed in the garment to temporarily stabilize them during transportation or while waiting for surgery / other treatment It is made of neoprene and Velcro, with a firm ball at the abdomen which compresses the uterus to decrease bleeding It can be used at all levels of health facilities (public and private) and in ambulances
- 17. UTEROTONICS SHOCK & NASG OUR WORK OVERVIEW Hypovolemic shock and how the NASG works Severe bleeding deprives vital organs of oxygen as blood accumulates in the lower body The NASG reverses shock by shunting blood from the lower extremities and abdomen to vital organs
- 18. UTEROTONICS SHOCK & NASG OUR WORK OVERVIEW CC-PPH model coverage Maternal mortality per 100,000 live births Bangladesh Peru India Tanzania Nigeria
- 19. UTEROTONICS SHOCK & NASG OUR WORK OVERVIEW Challenges in implementing the NASG Implementation of the garment requires frequent training and supportive supervision A danger of using the garment lies in the potential for untrained providers to remove it at the wrong time, causing rapid decompression and shock Logistic issues include getting the garment returned to it’s “home” site, properly cleaned, dried and stored, for use by the next PPH emergency case
- 20. Thank you! Let’s make the lives of every mother and child count!
Notas del editor
- Injectable uterotonics (oxytocin and ergometrine) are best kept in a refrigerator at 2–8°C.Ergometrine and syntometrine should be kept from freezing and light. Oxytocin may be kept outside the refrigerator at a maximum of 30°C for up to three months. What is the reality?Ergometrine and syntometrine vials may be kept outside the refrigerator in closed boxes and protected from light for up to one month at 30°C.When exposed to light, even indirect light, ergometrine and methylergometrine rapidly lose potency. When exposed to light oxytocin loses negligible amounts of potency.
- source USAID, POPPHI and MSH.
- It works by shunting blood accumulating in the lower extremities of the body back up to the vital organs, including the brain, heart, and lungs. Women who are in hypovolemic shock are placed in the garment as a temporary stabilizing measure during transportation to an appropriate facility or while waiting for surgery or other treatment to be organizedThe NASG is a garment made of panels of neoprene and Velcro, with a firm ball in the abdominal panel that compresses the uterus to decrease uterine bleeding. It is made to be worn on the lower part of the body. The NASG can be used at all levels of health facilities (public and private), and also in ambulances.
- Peru:PPH in Pre-service curriculum, Advocacy