Postpartum hemorrhage

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Initiative to Prevent Women from Bleeding to Death at Childbirth

Worldwide, postpartum hemorrhage (bleeding after childbirth) typically causes around 130,000 maternal deaths a year, about 1/3 of all maternal deaths. Approximately 12 million women a year suffer excessive postpartum bleeding according to a major Gates Foundation report. In parts of Niger, more than half the women who die at childbirth do so because of excessive bleeding.

Niger and HDI have teamed up for a nation-wide Initiative to Prevent Women from Bleeding to Death When They Give Birth, using fairly recent scientific advances.

Niger aims to give every birthing woman a dose of misoprostol, using the beneficial side-effect of an ulcer medication, a heat-stable tablet that helps prevent excessive bleeding when it is taken immediately after the baby is out, by stimulating uterine contractions. Medicines to prevent excessive bleeding after birth are effective in well over 90% of cases, when given right away. This simple intervention can be life-saving in a country where injectable medication cannot be given due to an unreliable cold chain and lack of injection supplies.

For women who suffer excessive bleeding in spite of a timely prevention-dose of misoprostol, 3-Step Treatment combines simple, effective, low-cost, proven technologies.

When prevention is not enough:

STEP 1. A treatment-dose (4 tablets) of misoprostol – cost under $1. If she is still bleeding after 25 minutes,

STEP 2. A Condom Tamponade inserted into the uterus and filled with 300-500 ml of water normally stops the bleeding within 6 minutes.

Created in Bangladesh by Prof. Sayeba Akhter, “A Condom Tamponade” is an effective, low-cost alternative to very expensive “balloon catheters”. An Intrauterine Condom Tamponade is created by typing a condom onto a catheter, suction catheters being the cheapest, inserting this into the bleeding uterus, and inflating it with water. This creates pressure against the bleeding surface, just as you apply pressure on the skin to stop bleeding there.

A Condom Tamponade Kit costs only $4.32, and these have saved many women’s lives. If she is still bleeding 6-12 minutes after inflating the intrauterine tamponade,

Step 3. Apply a Non-inflatable Anti-Shock Garment (NASG), and get her to surgery, even if far away.

Made of wetsuit material (neoprene) with Velcro closings, it takes 3 minutes to apply a NASG which can prevent her from dying of shock and blood-loss during transportation to a “Definitive Treatment Hospital” that can perform life-saving surgery.

Developed at the University of California, San Francisco, this new yet proven technology costs $1 or less per use. Although NASG’s cost $42 if one buys enough of them, each can be applied 60 -100 times when disinfected and cleaned correctly.

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