Abstract

Postpartum haemorrhage (PPH) accounts for a high proportion of maternal mortality and morbidity throughout the world. A uterine compression belt which has been developed recently represents a very low tech, low cost solution in managing postpartum haemorrhage. To evaluate the blood flow changes in pelvic vessels following application of the postpartum haemorrhage compression belt (Laerdal Global Health, Stavanger, Norway). The sample included healthy postpartum women within 6 hours of vaginal delivery. The study was performed at Teaching Hospital, Ragama, Sri Lanka. PPH compression belt was applied on the lower abdomen in a supine position with a slight lateral tilt. Patient’s pulse, blood pressure and Doppler indices (RI, PI and PFV) of the uterine, internal iliac and femoral arteries were measured using transabdominal Doppler ultrasonography. Lower limb oxygen saturation was also measured. Measurements were obtained by connecting the subjects to a multimonitor throughout the study period of 20 minutes. Median RI, PI and PFV was calculated and comparisons were made between the baseline and after belt application at 10 and 20 minutes. A total of 20 healthy women were included and the mean time from delivery to study inclusion was 2.5 (range 0.5–5.0) hours. There were no adverse outcomes or altered vital signs noted among participants. Overall there were no significant changes in the internal iliac, uterine and femoral artery blood flow after application of the compression belt. There were no significant changes in the internal iliac, uterine and femoral artery blood flow after application of the compression belt. This preliminary study only shows that the application of the PPH compression belt has no apparent adverse changes in the iliac, uterine and femoral artery blood flow in postpartum mothers.

Highlights

  • Postpartum haemorrhage (PPH) accounts for a high proportion of maternal mortality and morbidity throughout the world

  • Overall there were no significant changes in the internal iliac, uterine and femoral artery blood flow after application of the compression belt

  • There were no significant changes in the internal iliac, uterine and femoral artery blood flow after application of the compression belt

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Summary

Introduction

Postpartum haemorrhage (PPH) accounts for a high proportion of maternal mortality and morbidity throughout the world. Postpartum haemorrhage (PPH) is responsible for a high proportion of maternal mortality worldwide. More than 30% of the estimated 500,000 maternal deaths that occur globally each year are attributed to postpartum haemorrhage [1]. Sri Lanka has been exceptional in achieving World Health Organization (WHO) millennium development goals in maternal care [2]. The latest maternal mortality ratio (MMR) for Sri Lanka is 37.7 per 100 000 live births in 2013 and MMR remained low compared to other South Asian countries [2,3]. Despite the relative low figures, obstetric haemorrhage is an important cause of maternal deaths in Sri Lanka [4]

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