Non-pneumatic Anti-Shock Garments: Clinical Trials and Results

The International Federation of Gynecology and Obstetrics (FIGO)/International Confederation of Midwives (ICM) recommendations for active management of third-stage labor, including uterotonic prophylaxis with additional uterotonic treatment when necessary, clearly reduce the incidence of severe postpartum hemorrhage (PPH) due to uterine atony1. Despite this, many women suffer intractable PPH from atony or other obstetric etiologies, including genital lacerations, ruptured uterus, ruptured ectopic pregnancies, as well as placenta previa, accreta and abruption. Multiple blood transfusions are often required to resuscitate and stabilize these individuals, and the institution of hemostasis may require surgical interventions or procedures only available at tertiary levels with skilled providers. Until the time when quality comprehensive emergency obstetric care (CEmOC), including surgery and/or blood transfusions, is readily available for all women in all locations, strategies and technologies for treatment of hemorrhage and hypovolemic shock are of exceptional value, especially those that can be readily provided and easily applied, even by persons with little or no medical training. Among the most promising of technologies to reduce maternal mortality is the non-pneumatic anti-shock garment (NASG), a first-aid device that when appropriately used may reduce the mortality and morbidity associated with obstetric hemorrhage2–8.