Abstract
BackgroundPostpartum hemorrhage (PPH) is the leading cause of maternal deaths worldwide. This study sought to quantify the potential health impact (morbidity and mortality reductions) that a low-cost uterine balloon tamponade (UBT) could have on women suffering from uncontrolled PPH due to uterine atony in sub-Saharan Africa.MethodsThe Maternal and Neonatal Directed Assessment of Technology (MANDATE) model was used to estimate maternal deaths, surgeries averted, and cases of severe anemia prevented through UBT use among women with PPH who receive a uterotonic drug but fail this therapy in a health facility. Estimates were generated for the year 2018. The main outcome measures were lives saved, surgeries averted, and severe anemia prevented.ResultsThe base case model estimated that widespread use of a low-cost UBT in clinics and hospitals could save 6547 lives (an 11% reduction in maternal deaths), avert 10,823 surgeries, and prevent 634 severe anemia cases in sub-Saharan Africa annually.ConclusionsA low-cost UBT has a strong potential to save lives and reduce morbidity. It can also potentially reduce costly downstream interventions for women who give birth in a health care facility. This technology may be especially useful for meeting global targets for reducing maternal mortality as identified in Sustainable Development Goal 3.
Highlights
Postpartum hemorrhage (PPH) is the leading cause of maternal deaths worldwide
Our base scenario analysis found that approximately 6547 lives could be saved in subSaharan Africa (SSA) in 2018 if the uterine balloon tamponade (UBT) is used for women with both severe and nonsevere PPH in health facilities and hospitals (Fig. 1)
Severe anemia is not estimated in the model, published data suggest that approximately 12% of those who suffer from severe hemorrhage will suffer from severe anemia [7]
Summary
Postpartum hemorrhage (PPH) is the leading cause of maternal deaths worldwide. This study sought to quantify the potential health impact (morbidity and mortality reductions) that a low-cost uterine balloon tamponade (UBT) could have on women suffering from uncontrolled PPH due to uterine atony in sub-Saharan Africa. As the world seeks to achieve the Sustainable Development Goal (SDG) 3 maternal health targets—to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030 [3]—a key challenge will be to address the main causes of maternal death by increasing access to effective. Treatment for atony is clearly stated in global recommendations and follows a well-defined stepwise approach, including drugs and mechanical interventions followed by surgery as a last resort [5, 9]. Access to these key interventions is often lacking [10]. Obstetric surgical capabilities and emergency transportation are limited in low-resource settings, highlighting the need for effective treatments at the point of care
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