May 9, 2008

Simple Innovation Saves Women’s Lives

Around the globe, 500,000 women die every year from complications related to giving birth. The most common cause is obstetrical hemorrhage, or heavy bleeding, which can cause death in two hours or less.

Consider that in many rural areas a hospital can be hours or even days away, and the urgency of medical attention becomes clear. Given this dire situation, some health researchers are working on promoting the adoption of less-invasive, evidenced-based medical practices to prevent excess bleeding from occurring during childbirth and simple innovations that can help stem the blood flow when there is a problem.

One low-tech device that can be used to help women who are hemorrhaging and who don’t have immediate access to maternity care interventions is the LifeWrap. Also known as a non-pneumatic anti shock garment (NASG), the LifeWrap — which resembles a partial wet suit — is made of neoprene and Velcro, and it literally wraps around the lower body, using pressure to treat shock, resuscitate, stabilize and prevent further bleeding in women with obstetric hemorrhage.

Check out a video here to see how it works.

Dr. Suellen Miller, director of Safe Motherhood Programs at the UCSF BIxby Programs for Global Reproductive Health, is currently conducting foundation-funded studies of the LifeWrap to treat maternal hemorrhage in Nigeria, Mexico, Egypt, Zambia and Zimbabwe. She is also working with Pathfinder International on a postpartum hemorrhage project in India.

What has the research shown so far?

In 2004, Suellen Miller, Dr. Paul Hensleigh, and their Egyptian colleagues, conducted a pilot study at four large hospitals in Egypt. Study participants who suffered severe obstetrical hemorrhage and shock were treated according to standard management or standard management AND the LifeWrap.

There was a 50% decrease in bleeding for the women treated with standard care AND the LifeWrap. 75% fewer women in the LifeWrap died or had severe maternal morbidity.

That’s super impressive, but as the LifeWrap website points out, larger studies are needed, especially for funding.

These studies would provide the scientific, clinical and statistical evidence required by donor and advisory agencies (World Health Organization, UNICEF, UNFPA, USAID) before they will contribute the funds necessary to distribute the LifeWrap globally.

With Mother’s Day around the corner, now’s a great time to make a donation to LifeWrap to help speed up distribution — $160 buys one LifeWrap, which can be used up to 50 times.

In other news this week, a University of North Carolina at Chapel Hill School of Public Health study that was published in the New England Journal of Medicine found that relatively inexpensive interventions helped health care providers in Latin America improve the way they treat mothers during labor and delivery, especially when it came to reducing blood loss.

The teaching techniques focused on behavioral change strategies aimed at modifying practices. According to the study, researchers were able to reduce the number and severity of episiotomies at public hospitals in Argentina and Uruguay and increase the use of the hormone oxytocin – which is given to mothers to make their uterus shrink and bleed less during the third stage of labor.

“Both of these changes greatly reduced the amount of blood mothers lost during childbirth, with mothers in the intervention hospitals losing 44 percent less blood,” said Marci Campbell, a professor in the UNC School of Public Health whose research focuses on health interventions.

“This randomized trial showed that knowledge alone does not change behavior,” Campbell said. “It takes the combination of opinion leaders, personal visits, reminders, and support to change behavior. This change is especially important for developing countries where maternal hemorrhage is a major health threat. However, the intervention also could be beneficial in developed countries, including many parts of the United States, where rates of routine episiotomy are still above optimal.”


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