Maternal Health Innovations_Eltahir_5.13.11


Published on

Published in: Health & Medicine, Career
  • Be the first to comment

  • Be the first to like this

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide
  • Injectable uterotonics (oxytocin and ergometrine) are best kept in a refrigerator at 2–8°C.Ergometrine and syntometrine should be kept from freezing and light. Oxytocin may be kept outside the refrigerator at a maximum of 30°C for up to three months. What is the reality?Ergometrine and syntometrine vials may be kept outside the refrigerator in closed boxes and protected from light for up to one month at 30°C.When exposed to light, even indirect light, ergometrine and methylergometrine rapidly lose potency. When exposed to light oxytocin loses negligible amounts of potency.
  • source USAID, POPPHI and MSH.
  • It works by shunting blood accumulating in the lower extremities of the body back up to the vital organs, including the brain, heart, and lungs. Women who are in hypovolemic shock are placed in the garment as a temporary stabilizing measure during transportation to an appropriate facility or while waiting for surgery or other treatment to be organizedThe NASG is a garment made of panels of neoprene and Velcro, with a firm ball in the abdominal panel that compresses the uterus to decrease uterine bleeding. It is made to be worn on the lower part of the body. The NASG can be used at all levels of health facilities (public and private), and also in ambulances.
  • Peru:PPH in Pre-service curriculum, Advocacy
  • Maternal Health Innovations_Eltahir_5.13.11

    1. 1. Prevention and Management of PPH: <br />Utilizing Uterotonics and the Non-Pneumatic Anti-Shock Garment (NASG)<br />Dr. Abdelhadi Eltahir, Sr. Advisor for Maternal and Newborn Health<br />CORE Group Spring Meeting<br />EQUITY IN HEALTH: ENSURING ACCESS, INCREASING USE<br />Radisson Hotel, Baltimore May 9 to 13, 2011<br />
    2. 2.
    3. 3. OVERVIEW<br />UTEROTONICS<br />SHOCK & NASG<br />OUR WORK<br />The Clinical and Community Action Model for PPH (CC-PPH)<br /><ul><li>Early government support to ensure buy-in and adoption
    4. 4. Expanding clinical staff capacity to improve quality of services
    5. 5. Working with the community to overcome barriers</li></li></ul><li>Why PPH? <br />UTEROTONICS<br />SHOCK & NASG<br />OUR WORK<br />OVERVIEW<br />Postpartum hemorrhage (PPH) is a priority Issue for Pathfinder because:<br />PPH is a major cause of maternal mortality (25% to 60%), <br />PPH kills fast (as little as 2 hours from onset to death), <br />Death from PPH is preventable with prompt recognition and treatment <br />Addressing PPH comprehensively leads the way to effectively addressing all causes of maternal mortality. <br />Here is the baby, but where is the mother?<br />
    6. 6. Uterotonic drugs<br />UTEROTONICS<br />SHOCK & NASG<br />OUR WORK<br />OVERVIEW<br />Uterotonics are used to: <br /><ul><li>Prevent PPH when applying active management of the third stage of labor (AMTSL),
    7. 7. Induce or augment labor by;
    8. 8. Increasing frequency of contractions during labor,
    9. 9. Increasing intensity of contractions during labor, and
    10. 10. Enhance uterine contractions following spontaneous abortion. </li></li></ul><li>Uterotonic drugs<br />UTEROTONICS<br />SHOCK & NASG<br />OUR WORK<br />OVERVIEW<br />The commonly used uterotonics are:<br /><ul><li>Oxytocin
    11. 11. Ergometrine or syntometrine
    12. 12. Misoprostol</li></ul>Injectable uterotonic drugs are administered IM or IV<br />Tablet uterotonics are given orally, vaginally or rectally (for PPH) <br />
    13. 13. Retaining effectiveness and potency <br />UTEROTONICS<br />SHOCK & NASG<br />OUR WORK<br />OVERVIEW<br />Source: WHO, USAID, POPPHI<br />
    14. 14. UTEROTONICS<br />SHOCK & NASG<br />OUR WORK<br />OVERVIEW<br />Shift to best practice in use of uterotonics: Oxytocin<br />Oxytocin is the drug of choice for AMTSL<br />Administering oxytocin immediately after childbirth has led to significant impact in preventing and reducing PPH<br /> Demand remains high for AMTSL <br />
    15. 15. UTEROTONICS<br />SHOCK & NASG<br />OUR WORK<br />OVERVIEW<br />Addressing Hypovolemic Shock: <br />How the non-pneumatic anti-shock garment (NASG) works<br />
    16. 16. UTEROTONICS<br />SHOCK & NASG<br />OUR WORK<br />OVERVIEW<br />The non-pneumatic anti-shock garment (NASG)<br />The NASG shunts blood accumulating in the lower extremities back up to the vital organs, including the brain, heart, and lungs <br />Women in shock are placed in the garment to temporarily stabilize them during transportation or while waiting for surgery / other treatment <br />It is made of neoprene and Velcro, with a firm ball at the abdomen which compresses the uterus to decrease bleeding<br />It can be used at all levels of health facilities (public and private) and in ambulances<br />
    17. 17. UTEROTONICS<br />SHOCK & NASG<br />OUR WORK<br />OVERVIEW<br />Hypovolemic shock and how the NASG works<br />Severe bleeding deprives vital organs of oxygen as blood accumulates in the lower body<br />The NASG reverses shock by shunting blood from the lower extremities and abdomen to vital organs<br />
    18. 18. UTEROTONICS<br />SHOCK & NASG<br />OUR WORK<br />OVERVIEW<br />CC-PPH model coverage<br />Maternal mortality per 100,000 live births<br />Bangladesh<br />Peru<br />India<br />Tanzania<br />Nigeria<br />
    19. 19. UTEROTONICS<br />SHOCK & NASG<br />OUR WORK<br />OVERVIEW<br />Challenges in implementing the NASG<br />Implementation of the garment requires frequent training and supportive supervision<br />A danger of using the garment lies in the potential for untrained providers to remove it at the wrong time, causing rapid decompression and shock<br />Logistic issues include getting the garment returned to it’s “home” site, properly cleaned, dried and stored, for use by the next PPH emergency case<br />
    20. 20. Thank you!<br />Let’s make the lives of every mother and child count!<br />