Nonatonic obstetric haemorrhage: effectiveness of the nonpneumatic antishock garment in egypt.

The study aims to determine if the nonpneumatic antishock garment (NASG), a first aid compression device, decreases severe adverse outcomes from nonatonic obstetric haemorrhage. Women with nonatonic aetiologies (434), blood loss > 1000 mL, and signs of shock were eligible. Women received standard care during the preintervention phase (226) and standard care plus application of the garment in the NASG phase (208). Blood loss and extreme adverse outcomes (EAO-mortality and severe morbidity) were measured. Women who used the NASG had more estimated blood loss on admission. Mean measured blood loss was 370 mL in the preintervention phase and 258 mL in the NASG phase (P < 0.0001). EAO decreased with use of the garment (2.9% versus 4.4%, (OR 0.65, 95% CI 0.24-1.76)). In conclusion, using the NASG improved maternal outcomes despite the worse condition on study entry. These findings should be tested in larger studies

Obstetric hemorrhage and shock management: using the low technology Non-pneumatic Anti-Shock Garment in Nigerian and Egyptian tertiary care facilities

Abstract Background Obstetric hemorrhage is the leading cause of maternal mortality globally. The Non-pneumatic Anti-Shock Garment (NASG) is a low-technology, first-aid compression device which, when added to standard hypovolemic shock protocols, may improve outcomes for women with hypovolemic shock secondary to obstetric hemorrhage in tertiary facilities in low-resource settings. Methods This study employed a pre-intervention/intervention design in four facilities in Nigeria and two in Egypt. Primary outcomes were measured mean and median blood loss, severe end-organ failure morbidity (renal failure, pulmonary failure, cardiac failure, or CNS dysfunctions), mortality, and emergency hysterectomy for 1442 women with ≥750 mL blood loss and at least one sign of hemodynamic instability. Comparisons of outcomes by study phase were assessed with rank sum tests, relative risks (RR), number needed to treat for benefit (NNTb), and multiple logistic regression. Results Women in the NASG phase (n = 835) were in worse condition on study entry, 38.5% with mean arterial pressure <60 mmHg vs. 29.9% in the pre-intervention phase (p = 0.001). Despite this, negative outcomes were significantly reduced in the NASG phase: mean measured blood loss decreased from 444 mL to 240 mL (p < 0.001), maternal mortality decreased from 6.3% to 3.5% (RR 0.56, 95% CI 0.35-0.89), severe morbidities from 3.7% to 0.7% (RR 0.20, 95% CI 0.08-0.50), and emergency hysterectomy from 8.9% to 4.0% (RR 0.44, 0.23-0.86). In multiple logistic regression, there was a 55% reduced odds of mortality during the NASG phase (aOR 0.45, 0.27-0.77). The NNTb to prevent either mortality or severe morbidity was 18 (12-36). Conclusion Adding the NASG to standard shock and hemorrhage management may significantly improve maternal outcomes from hypovolemic shock secondary to obstetric hemorrhage at tertiary care facilities in low-resource settings

Gynaecological and related Morbidities among ever-married Omani Women

To assess the prevalence and correlates of gynecologic and related morbidity in Omani women, a nationally representative sample of Omani women selected by a multi-stage, stratified probability sampling procedure was selected (total = 364). Questionnaire interview, physical and gynecological examination, and laboratory investigations were used to elicit information. The prevalence of lower reproductive tract infections was 22.4%, upper reproductive tract infections 2.7%, and cervical dysplasia was very rare. Genital prolapse was present in 10%, 11% had a urinary infection, 27% were anaemic, 23% were hypertensive, and 54% were either overweight or obese. The predictors of common morbidities were assessed using regression analysis according to a pre-specified conceptual model.Key words: Morbidity, prevalence, community Résumé Les morbidités associées et gynécologiques chez les femmes omanaises jamais mariées Afin d\'évaluer la prévalence et les corrélats de la morbidité associée et gynécologiques chez les femmes omanaises, un échantillon nationalement représentative des femmes omanaises qui été selectionné à travers un processus d\'échantillonage de probabilité stratifiée à stades multiples a été selectionné (364 au total). Pour obtenir des renseignements, on s\'est servi des interviews à questionnaire, des examens physiques et gynécologiques ainsi que des investigations de laboratoire. La prévalence des infections de la voie de reproduction inférieure était de 24%, des infections de la voie de reproduction supérieure était de 2,7% alors que la dysplasie cervicale était rare. 10% des femmes ont présenté le prolapsus génital, 11% avaient de l\'infection urinaire, 27% ont été anémique, 23% ont été hypertendues et 54% avaient une surcharge pondérale ou étaient obèses. Les indices des morbidités ordinaires ont été évalués à l\'aide de l\'analyse de la regression d\'après un modèle conceptuel pré-dénommé. African Journal of Reproductive Health Vol. 8 (3) 2004: 188-19