Abstract
Complications from unsafe abortion are among the major causes of preventable maternal morbidity and mortality, which may be compounded by delays and disparities in treatment. We conducted a secondary analysis of women with symptoms of hypovolemic shock secondary to severe obstetric hemorrhage in Tanzania. We compared receipt of three lifesaving interventions among women with abortions versus other maternal hemorrhage etiologies. Interventions included: non-pneumatic anti-shock garment (NASG) (N = 393), blood transfusion (N = 249), and referral to a higher-capacity facility (N = 131). After controlling for severity of disease and other confounders, women with abortion-related hemorrhage and shock had 78percent decreased odds of receiving NASG (p < 0.001) and 77percent decreased odds of receiving a blood transfusion (p < 0.001) compared to women with hemorrhage and shock from other etiologies. Our findings suggest that, in Tanzania, women with abortion-related hemorrhage received lower quality of care than women with other hemorrhage etiologies.
Highlights
Obstetric hemorrhage (OH) remains one of the leading causes of maternal mortality, in rural Africa
OH can lead to shock, a state in which the body’s vital organs lack enough oxygen, which leads to organ failure and death
In Tanzania women die from bleeding and shock due to long distances from emergency health services, Comprehensive Emergency Obstetric Care (CEmOC). One way this problem has been addressed is with the use of a lightweight, cost-efficient compression garment, the non-pneumatic anti-shock garment (NASG), which stabilizes women who have lost excessive blood, allowing them to survive delays in travelling to or receiving care at CEmOC facilities
Summary
Obstetric hemorrhage (OH) remains one of the leading causes of maternal mortality, in rural Africa. This low-technology, easy to apply, circumferential pressure device, is made of stretchy compression neoprene and closes tightly with Velcro, reversing shock, restoring vital signs, and decreasing blood loss in the pelvis and uterus [5] This first aid device buys valuable time, to enable transfer from rural and lower level facilities, and during the often-long delays for blood transfusions or surgeries that can occur, even in tertiary and university teaching hospitals in LRCs. Morbidity and mortality outcomes using the NASG have been positively compared to outcomes with standard treatment of shock/hemorrhage in women with a variety of OH etiologies, and the NASG was found to be effective in decreasing blood loss by over 50% [6–9].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
