Provider experiences with improvised uterine balloon tamponade for the management of uncontrolled postpartum hemorrhage in Kenya

被引：10

作者：

Natarajan, Abirami ^{[1
,2
]}

Pendleton, Anna Alaska ^{[1
,2
]}

Nelson, Brett D. ^{[1
,2
]}

Ahn, Roy ^{[1
]}

Oguttu, Monica ^{[3
]}

Dulo, Lidu ^{[3
]}

Eckardt, Melody J. ^{[1
]}

Burke, Thomas F. ^{[1
,2
]}

机构：

[1] Massachusetts Gen Hosp, Dept Emergency Med, Div Global Hlth & Human Rights, 125 Nashua St,Suite 910, Boston, MA 02114 USA

[2] Harvard Med Sch, Boston, MA USA

[3] Kisumu Med Educ Trust, Kisumu, Kenya

来源：

INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS | 2016年 / 135卷 / 02期

基金：

比尔及梅琳达.盖茨基金会;

关键词：

Kenya; Maternal health; Maternal hemorrhage; Maternal mortality; Postpartum hemorrhage; Uterine balloon tamponade; MATERNAL DEATH;

D O I：

10.1016/j.ijgo.2016.05.006

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Objective: To understand healthcare providers' experiences with improvised uterine balloon tamponade (UBT) for the management of uncontrolled postpartum hemorrhage (PPH). Methods: In a qualitative descriptive study, in-depth semi-structured interviews were conducted between November 2014 and June 2015 among Kenyan healthcare providers who had previous experience with improvising a UBT device. Interviews were conducted, audio-recorded, and transcribed. Results: Overall, 29 healthcare providers (14 nurse-midwifes, 7 medical officers, 7 obstetricians, and 1 clinical officer) were interviewed. Providers perceived improvised UBT as valuable for managing uncontrolled PPH. Reported benefits included effectiveness in arresting hemorrhage and averting hysterectomy, and ease of use by providers of all levels of training. Providers used various materials to construct an improvised UBT. Challenges to improvising UBT-e.g. searching for materials during an emergency, procuring male condoms, and inserting fluid via a small syringe were reported to lead to delays in care. Providers described their introduction to improvised UBT through both formal and informal sources. There was universal enthusiasm for widespread standardized training. Conclusion: Improvised UBT seems to be a valuable second line treatment for uncontrolled PPH that can be used by providers of all levels. UBT might be optimized by integrating a standard package across the health system. (C) 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd.

引用

页码：210 / 213

页数：4

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