A postpartum XXXX package with condom uterine balloon tamponade: a prospective multi-centre case series in Kenya, Sierra Leone, Senegal, and Nepal.

@entity1 @entity548 @entity7288 @entity397 @entity5280
OBJECTIVE: To evaluate the effectiveness and safety of an ultra-low-cost uterine balloon tamponade package (ESM-UBT   ) for facility-based management of uncontrolled postpartum @entity548 (PPH) in Kenya, Sierra Leone, Senegal, and Nepal. DESIGN: Prospective multi-centre case series. SETTING: Facilities in resource-scarce areas of Kenya, Sierra Leone, Nepal, and Senegal. POPULATION: @entity1 with uncontrolled postpartum @entity548 in 307 facilities across the four countries. METHODS: A standardised ESM-UBT package was implemented in 307 facilities over 29  months (1 September 2012 to 1 February 2015). Data were collected via a multi-pronged approach including data card completion, chart reviews, and provider interviews. Beginning in August 2014, @entity1 who had previously undergone UBT placement were sought and queried regarding potential complications associated with UBT use. MAIN OUTCOME MEASURES: All-cause survival, survival from PPH, and post-UBT use complications (surgery, hospitalisation, antibiotics for @entity5280 ) associated with UBT use. RESULTS: 201 UBTs were placed for uncontrolled vaginal @entity548 refractory to all other interventions. In all, 38% (71/188) of @entity1 were either unconscious or confused at the time of UBT insertion. All-cause survival was 95% (190/201). However, 98% (160/163) of @entity1 survived uncontrolled PPH if delivery occurred at an ESM-UBT online facility. One (1/151) potential UBT-associated complication (postpartum @entity7288 ) was identified and two improvised UBTs were placed in @entity1 with a @entity397 . CONCLUSIONS: These pilot data suggest that the ESM-UBT package is a clinically promising and safe method to arrest uncontrolled postpartum @entity548 and save @entity1 's lives. The UBT was successfully placed by all levels of facility-based providers. Future studies are needed to further evaluate the effectiveness of ESM-UBT in low-resource settings. TWEETABLE ABSTRACT: Evidence for ESM-UBT as a clinically promising and safe method to arrest uncontrolled PPH and save @entity1 's lives.
