Anti-Shock Garments for Obstetric Hemorrhage

Abstract

Annually, over 500,000 women die from complications of pregnancy and childbirth; the majority die fromhemorrhage and shock. Obstetrical hemorrhage of all etiologies, such as uterine atony, ruptured uterus, and rupturedectopic, can cause massive blood loss resulting in severe shock. Unless women can access fluid replacement, bloodtransfusions, and, often, surgery, the shock leads to organ failure and death. Therefore, the majority of maternalhemorrhage deaths occur in developing countries. The non-pneumatic anti-shock garment (NASG) is a light-weight,reusable, neoprene and Velcro compression device that can be rapidly applied to a hemorrhaging woman to shunt bloodfrom the lower extremities to the core organs, heart, lung and brain, and to decrease blood loss. We review literature onthe history, mechanisms of action, and use of Anti-Shock Garments (ASGs) in emergency medicine, focusing on the useof inflatable or Pneumatic ASGs (PASGs) for obstetrical, gynecological, and urological hemorrhage. We descri besimilarities and differences between the PASG and the newer NASG. We then review recent studies on the NASG forobstetrical hemorrhage in Pakistan, Nigeria, and Egypt, and conclude with recommendations for the types of researchnecessary to bring the NASG into wider use.