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Prevention and Management of PPH: <br />Utilizing Uterotonics and the Non-Pneumatic Anti-Shock Garment (NASG)<br />Dr. Abd...
OVERVIEW<br />UTEROTONICS<br />SHOCK & NASG<br />OUR WORK<br />The Clinical and Community Action Model for PPH (CC-PPH)<br...
Expanding clinical staff capacity to improve quality of services
Working with the community to overcome barriers</li></li></ul><li>Why PPH? <br />UTEROTONICS<br />SHOCK & NASG<br />OUR WO...
Uterotonic drugs<br />UTEROTONICS<br />SHOCK & NASG<br />OUR WORK<br />OVERVIEW<br />Uterotonics are used to: <br /><ul><l...
Induce or augment labor by;
Increasing frequency of contractions during labor,
Increasing intensity of contractions during labor, and
Enhance uterine contractions following spontaneous abortion. </li></li></ul><li>Uterotonic drugs<br />UTEROTONICS<br />SHO...
Ergometrine or syntometrine
Misoprostol</li></ul>Injectable uterotonic drugs are administered IM or IV<br />Tablet uterotonics are given orally, vagin...
Retaining effectiveness and potency <br />UTEROTONICS<br />SHOCK & NASG<br />OUR WORK<br />OVERVIEW<br />Source: WHO, USAI...
UTEROTONICS<br />SHOCK & NASG<br />OUR WORK<br />OVERVIEW<br />Shift to best practice in use of uterotonics: Oxytocin<br /...
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Maternal Health Innovations_Eltahir_5.13.11

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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 />

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