Maternal death and disability is the greatest health disparity on earth between the poor and those that are fortunate to live in prosperity. It is estimated that 2.8 million women annually either lose their lives or become injured from pregnancy related causes, with postpartum hemorrhage (PPH) being the most common reason. The majority of our world’s pregnant women that lose their lives each year, live in India. Through integration and bundling of the award-­‐winning innovation, “Every Second Matters for Mothers and Babies -­‐ Uterine Balloon Tamponade” (ESM-­‐UBT) package into the clinical practice of maternal care, postpartum hemorrhage deaths and disabilities in India can be averted. Over 90% of all of these deaths occur in low resource settings, where adequate equipment and /or training might not be available to manage the issue.

ESM UBT: The ESM-­‐UBT package is ultra-­‐low-­‐cost, easy to use, safe and highly cost-­‐effective. It is designed to address the number one killer of pregnant women in the world. The ESM-­‐UBT device rapidly halts blood loss in women suffering from uncontrolled PPH. One of the most effective ways to manage the issue is a Uterine Balloon Tamponade device (UBT) which presses against the inner walls of the uterus to halt the excessive bleeding.

Introduction of ESM-­‐UBT in India: Since 2012, the WHO PPH guidelines have recommended use of uterine balloon tamponade for uncontrolled PPH. Since 2015, condom uterine balloon tamponade has been integrated into the National Policy of India as best practice care for treatment in PPH.

Pregna International Ltd. has teamed up with Dr. Thomas Burke (Harvard University) Vayu Global Health Foundation to introduce the ESM UBT kit.

The intervention involves inserting a balloon into the uterus and then filling the balloon with liquid, which applies pressure to the uterus until the bleeding stops. Effective treatment occurs rapidly within 5 to 15 minutes after insertion and inflation of the balloon

Even when UBT cannot completely control severe PPH, it serves a critical role by reducing blood loss until the woman can be transported to a facility with surgical and other treatment options.

At a time when every second matters, Dr. Burke’s ESM-UBT kit eliminates the time required in procuring the required components.

It reduces the expense of assembling, procuring and reprocessing the components from various sources

Single use device reduces the risk of cross-contamination

Effective in rapid treatment of PPH, within 5 to 15 minutes after insertion and inflation

Each kit is assembled with all components required to adequately handle PPH, making it suitable even for low-resource settings

With all the components packed in an easy to store kit, it increases the efficacy of medical staff in the event of an emergency

The compactness of the kit allows it to be easily carried from one location to another

Easy to assemble with minimal training required.

Uterine Balloon Tamponade
Effective in rapid treatment of Postpartum Bleeding
Single use device reduces the risk of cross contamination
Easy to assemble with minimal training required
Majority of deaths are preventable
Postpartum Hemorrhage
What is postpartum hemorrhage?
Postpartum hemorrhage is more bleeding than normal after the birth of a baby. About 1 in 100 to 5 in 100 women have postpartum hemorrhage. It is more likely with a cesarean birth. It most often happens after the placenta is delivered, but it can also happen later.
What causes postpartum hemorrhage?
Once a baby is delivered, the uterus normally contracts and pushes out the placenta. After the placenta is delivered, these contractions help put pressure on the bleeding vessels in the area where the placenta was attached. If the uterus does not contract strongly enough, these blood vessels bleed freely. This is the most common cause of postpartum hemorrhage. If small pieces of the placenta stay attached, bleeding is also likely.
Postpartum hemorrhage may also be caused by:
  • Tear in the cervix or tissues of the vagina
  • Tear in a blood vessel in the uterus
  • Bleeding into a hidden tissue area or space in the pelvis. This mass of blood is called a hematoma. It is usually in the vulva or vagina.
  • Blood clotting disorders
  • Placenta problems
Who is at risk for postpartum hemorrhage?
Some women are at greater risk for postpartum hemorrhage than others. Conditions that may increase the risk include:
  • Placental abruption. This is the early detachment of the placenta from the uterus.
  • Placenta Previa. This is when the placenta covers or is near the opening of the cervix.
  • Over distended uterus. This is when the uterus is larger than normal because of too much amniotic fluid or a large baby.
  • Multiple-baby pregnancy
  • High blood pressure disorders of pregnancy
  • Having many previous births
  • Prolonged labor
  • Infection
  • Obesity
  • Use of forceps or vacuum-assisted delivery
  • Being of Asian or Hispanic ethnic background
What are the symptoms of postpartum hemorrhage?
These are the most common symptoms of postpartum hemorrhage:
  • Uncontrolled bleeding
  • Decreased blood pressure
  • Increased heart rate
  • Decrease in the red blood cell count
  • Swelling and pain in the vagina and nearby area if bleeding is from a hematoma
  • The symptoms of postpartum hemorrhage may look like other health conditions. Always see your healthcare provider for a diagnosis.
  • How is postpartum hemorrhage diagnosed?
    Your healthcare provider will review your health history and do a physical exam. Lab tests often help with the diagnosis. Other tests may include:
  • Estimate of how much blood you have lost
  • Measuring pulse and blood pressure
  • Red blood cell count
  • Clotting factors in the blood
  • How is postpartum hemorrhage treated?
    The aim of treatment of postpartum hemorrhage is to find and stop the cause of the bleeding as soon as possible. Treatment may include:
  • Medicine or uterine massage to stimulate uterine contractions
  • Removing pieces of the placenta that remain in the uterus
  • Exam of the uterus and other pelvic tissues, the vagina, and the vulva to look for areas that may need repair
  • Bakri balloon or a Foley catheter to put pressure on the bleeding inside the uterus. Your healthcare provider may pack the uterus with sponges and sterile materials. This may be done if a Bakri balloon or Foley catheter is not available.
  • Laparotomy. This is surgery to open the abdomen to find the cause of bleeding.
  • Tying off or sealing bleeding blood vessels. This is done using uterine compression sutures, special gel, glue, or coils. The surgery is done during a laparotomy.
  • Hysterectomy. This is surgery to remove the uterus. In most cases, this is a last resort.
  • Replacing lost blood and fluids is important in treating postpartum hemorrhage. You may quickly be given IV (intravenous) fluids, blood, and blood products to prevent shock. Oxygen may also help.
  • Postpartum hemorrhage can be quite serious. But when your provider quickly finds and treats the cause of bleeding, you often will be able to recover fully.
  • What are possible complications of postpartum hemorrhage?
    Losing lots of blood quickly can cause a severe drop in your blood pressure. This may lead to shock and death if not treated.

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