Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM, USA.
Department of Emergency Medicine, University of New Mexico, Albuquerque, NM, USA.
Int J Gynaecol Obstet. 2020 Oct;151(1):97-102. doi: 10.1002/ijgo.13291. Epub 2020 Jul 31.
To evaluate obstetric hemorrhage outcomes and present data specific to adoption of pneumatic circumferential abdominopelvic compression devices.
Two resource-limited locations added low-cost pneumatic compression devices to their standard protocols for obstetric hemorrhage between 2010 and 2019. Providers in rural Nepal and Papua New Guinea used devices that incorporated a bicycle tube or soccer ball ("Ball and Binder") to provide abdominopelvic pressure after all available routine treatments had failed. Data were collected during the entire period as part of ongoing obstetric quality improvement. Data presented include obstetric event, etiology of bleeding, need for surgery, transfusion, transport, length of transports, maternal survival, and complications.
Circumferential abdominopelvic compression was used 106 times. The devices were used primarily after vaginal birth with atony, but also for obstetrical lacerations, miscarriages, and post-abortion bleeding. In all cases the bleeding stopped "promptly." All women survived, none required hysterectomy, and no complications were reported resulting from device use. Only 15 (14%) patients were transported to a referral hospital.
In this quality improvement project, obstetric hemorrhage was controlled when circumferential pressure was applied after usual care had failed.
评估产科出血结局，并提供特定于采用气动环形腹盆腔压迫装置的数据。
2010 年至 2019 年期间，两个资源有限的地点在其产科出血的标准方案中增加了低成本的气动压缩装置。尼泊尔农村和巴布亚新几内亚的提供者使用了一种装置，该装置将自行车内胎或足球（“球和绑带”）结合在一起，在所有可用的常规治疗方法均失败后提供腹盆腔压力。在整个期间，数据都作为正在进行的产科质量改进的一部分进行收集。呈现的数据包括产科事件、出血病因、手术需求、输血、转运、转运时间、产妇存活率和并发症。
环形腹盆腔压迫使用了 106 次。这些装置主要用于因宫缩乏力导致的阴道分娩后，但也用于产科裂伤、流产和流产后出血。在所有情况下，出血都“迅速”停止。所有女性均存活，无一例需要子宫切除术，也未报告因使用装置而导致的任何并发症。只有 15 名（14%）患者被转运到转诊医院。
在这项质量改进项目中，在常规护理失败后应用环形压力时，产科出血得到了控制。
