A low-cost, life-saving intervention

Early this month, at the Chirayinkeezhu taluk headquarters hospital, Sarita, 28, went into labour and was delivered of a baby. The delivery was normal and the woman had no post-partum haemorrhage (PPH). Thus, it took the labour room staff by surprise when the mother’s blood pressure dropped dangerously and her pulse rate went up, indicating that she was going into obstetric shock.

“Though Code Blue was called and everyone rushed in, we were losing her. But our gynaecologist stepped in and had the woman wrapped in a Non-Pneumatic Anti-Shock Garment (NASG). The hospital had been provided this garment just the previous day, after a training programme conducted by the Health Department for maternal care staff,” S. Raju, Superintendent, Chirayinkeezhu hospital, said. The hospital handled about 300 deliveries a month.

“The recovery was near-miraculous. Within minutes, her BP shot up, pulse rate reduced, and we could stabilise her. She was rushed to SAT Hospital wearing the NASG, where she was revived properly. If not for this innovation called NASG, the picture might have been quite different,” Dr. Raju said.

The young woman who was brought back to life would probably never know about those crucial moments when the situation had been touch and go. But to all those who were present in the labour room that day, it was a clear demonstration of the potential of a low-cost, low-tech obstetric intervention called NASG to save the lives of mothers at critical junctures.

NASG is a modified version of the inflatable suit used by the military since 1900s and it has been saving the lives of mothers in many low-resource countries for the past one decade.

WHO recommendation

Last year, the WHO, in its latest recommendation on managing PPH, endorsed the use of NASGs ‘as a temporising measure till appropriate care is available’ and suggested that national guidelines be reviewed to include NASGs as a low-tech first aid for PPH.

Pathfinder International, a not-for-profit global organisation in the area of reproductive health, had provided 15 NASGs free of cost to the Health Department and trained gynaecologists so that the State may have a firsthand experience of this intervention.

“Tamil Nadu was the first State to move for the introduction of NASGs, in 2008. It has 1,200 of these garments and every maternity hospital and 108 ambulance in the State has one. Its maternity care staff in all districts are trained in using NASG and have managed to save innumerable lives,” N.S. Iyer, the national master-trainer for Continuum of Care for PPH, a project of Pathfinder International, told The Hindu .

NASG has become the latest addition to the slew of interventions, guidelines, and protocols which are being introduced by the Health Department in an intensive drive to achieve a reduction in the State’s maternal mortality. The garments have been distributed to all five Government Medical College hospitals: SAT Hospital, Thiruvananthapuram; Women and Children Hospital, Thycaud, Thiruvananthapuram; General Hospital, Ernakulam; Community Health Centress at Kanyakulangara and Poonthura; Peroorkada district hospital; and taluk hospitals at Chirayinkeezhu, Parassala, Neyyattinkara, and Nedumangad.

The department will review the experience of the hospitals where NASG has been provided and then make a recommendation to the government on its formal introduction.

NASG is a modified version of the inflatable suit used by the military since 1900s and it has been saving the lives of mothers in many low-resource countries for a decade now.

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