6 results on '"Oguttu, Monica"'
Search Results
2. Safety of a condom uterine balloon tamponade (ESM-UBT) device for uncontrolled primary postpartum hemorrhage among facilities in Kenya and Sierra Leone.
- Author
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Ramanathan A, Eckardt MJ, Nelson BD, Guha M, Oguttu M, Altawil Z, and Burke T
- Subjects
- Adolescent, Adult, Costs and Cost Analysis, Female, Health Facilities statistics & numerical data, Hemostatic Techniques economics, Humans, Kenya, Postpartum Hemorrhage economics, Pregnancy, Retrospective Studies, Sierra Leone, Treatment Outcome, Uterine Balloon Tamponade economics, Uterine Balloon Tamponade statistics & numerical data, Young Adult, Condoms, Female economics, Hemostatic Techniques instrumentation, Postpartum Hemorrhage therapy, Uterine Balloon Tamponade methods
- Abstract
Background: Postpartum hemorrhage is the leading cause of maternal mortality in low- and middle-income countries. While evidence on uterine balloon tamponade efficacy for severe hemorrhage is encouraging, little is known about safety of this intervention. The objective of this study was to evaluate the safety of an ultra-low-cost uterine balloon tamponade package (named ESM-UBT) for facility-based management of uncontrolled postpartum hemorrhage (PPH) in Kenya and Sierra Leone., Methods: Data were collected on complications/adverse events in all women who had an ESM-UBT device placed among 92 facilities in Sierra Leone and Kenya, between September 2012 and December 2015, as part of a multi-country study. Three expert maternal health investigator physicians analyzed each complication/adverse event and developed consensus on whether there was a potential causal relationship associated with use of the ESM-UBT device. Adverse events/complications specifically investigated included death, hysterectomy, uterine rupture, perineal or cervical injury, serious or minor infection, and latex allergy/anaphylaxis., Results: Of the 201 women treated with an ESM-UBT device in Kenya and Sierra Leone, 189 (94.0%) survived. Six-week or longer follow-up was recorded in 156 of the 189 (82.5%). A causal relationship between use of an ESM-UBT device and one death, three perineal injuries and one case of mild endometritis could not be completely excluded. Three experts found a potential association between these injuries and an ESM-UBT device highly unlikely., Conclusion: The ESM-UBT device appears safe for use in women with uncontrolled PPH., Trial Registration: Trial registration was not completed as data was collected as a quality assurance measure for the ESM-UBT kit.
- Published
- 2018
- Full Text
- View/download PDF
3. Shock progression and survival after use of a condom uterine balloon tamponade package in women with uncontrolled postpartum hemorrhage.
- Author
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Burke TF, Danso-Bamfo S, Guha M, Oguttu M, Tarimo V, and Nelson BD
- Subjects
- Adolescent, Adult, Africa epidemiology, Emergency Treatment, Female, Humans, Maternal Health Services, Middle Aged, Postpartum Hemorrhage mortality, Pregnancy, Prospective Studies, Shock mortality, Survival Analysis, Young Adult, Postpartum Hemorrhage prevention & control, Shock prevention & control, Uterine Balloon Tamponade statistics & numerical data
- Abstract
Objective: To examine the outcomes of women in advanced shock from uncontrolled postpartum hemorrhage (PPH) who underwent placement of an Every Second Matters for Mothers and Babies Uterine Balloon Tamponade (ESM-UBT) device., Methods: In a prospective case series, data were collected for women who received an ESM-UBT device at healthcare facilities in Kenya, Senegal, Sierra Leone, and Tanzania between September 1, 2012, and September 30, 2016. Shock class was assigned on the basis of recorded blood pressures and mental status at the time of UBT placement., Results: Data for 306 women with uncontrolled PPH from uterine atony across 117 facilities were analyzed. Normal vital signs or class I/II shock were reported for 166 (54.2%). In this group, one death occurred and was attributed to PPH (survival rate 99.4%). There were no cases of shock progression. One hundred and eleven (36.3%) were in class III shock and 29 (9.5%) in class IV shock; the respective survival rates were 97.3% (n=108) and 86.2% (n=25)., Conclusion: The ESM-UBT device arrests hemorrhage, prevents shock progression, and is associated with high survival rates among women with uncontrolled PPH from uterine atony., (© 2017 International Federation of Gynecology and Obstetrics.)
- Published
- 2017
- Full Text
- View/download PDF
4. Cost-effectiveness of condom uterine balloon tamponade to control severe postpartum hemorrhage in Kenya.
- Author
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Mvundura M, Kokonya D, Abu-Haydar E, Okoth E, Herrick T, Mukabi J, Carlson L, Oguttu M, and Burke T
- Subjects
- Adult, Cross-Sectional Studies, Female, Humans, Kenya, Maternal Health Services economics, Maternal Mortality, Perinatal Care economics, Postpartum Hemorrhage economics, Postpartum Hemorrhage mortality, Pregnancy, Condoms statistics & numerical data, Postpartum Hemorrhage therapy, Uterine Balloon Tamponade instrumentation
- Abstract
Objective: To evaluate the cost-effectiveness of condom uterine balloon tamponade (UBT) for control of severe postpartum hemorrhage (PPH) due to uterine atony versus standard PPH care in Kenya., Methods: A cross-sectional analysis was conducted using cost data collected from 30 facilities in Western Kenya from April 15 to July 16, 2015. Effectiveness data were derived from the published literature. The modeling analysis was performed from the health-system perspective for a cohort of women who gave birth in 2015. Sensitivity analyses tested the robustness of model estimates. Costs were in 2015 US dollars., Results: Compared with standard care with no uterine packing, condom UBT could prevent 1255 hospital transfers, 430 hysterectomies, and 44 maternal deaths. At $5 or $15 per UBT device, the incremental cost per disability-adjusted life year (DALY) averted was $26 or $40, respectively. If uterine packing was assumed to be done with standard care, the cost per DALY averted was $164 when the UBT price was $5 and $199 when the price was $15., Conclusion: Condom UBT was a highly cost-effective intervention for controlling severe PPH. This finding remained robust even when key model inputs were varied by wide margins., (© 2017 International Federation of Gynecology and Obstetrics.)
- Published
- 2017
- Full Text
- View/download PDF
5. Provider experiences with improvised uterine balloon tamponade for the management of uncontrolled postpartum hemorrhage in Kenya.
- Author
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Natarajan A, Alaska Pendleton A, Nelson BD, Ahn R, Oguttu M, Dulo L, Eckardt MJ, and Burke TF
- Subjects
- Disease Management, Female, Health Personnel, Humans, Kenya, Maternal Mortality, Qualitative Research, Condoms statistics & numerical data, Hysterectomy adverse effects, Postoperative Complications therapy, Postpartum Hemorrhage therapy, Uterine Balloon Tamponade instrumentation
- Abstract
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., (Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2016
- Full Text
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6. Provider experiences with uterine balloon tamponade for uncontrolled postpartum hemorrhage in health facilities in Kenya.
- Author
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Natarajan A, Chavez J, Ahn R, Nelson BD, Eckardt M, Dulo L, Achieng E, Oguttu M, Tester K, and Burke TF
- Subjects
- Adult, Female, Health Facilities, Health Personnel education, Humans, Kenya, Middle Aged, Pregnancy, Qualitative Research, Treatment Outcome, Uterine Balloon Tamponade instrumentation, Attitude of Health Personnel, Delivery, Obstetric education, Health Personnel psychology, Postpartum Hemorrhage therapy, Uterine Balloon Tamponade psychology
- Abstract
Objective: To understand provider perceptions and experiences following training in the use of a condom-catheter uterine balloon tamponade (UBT) as second-line treatment for uncontrolled postpartum hemorrhage (PPH) in health facilities in Kenya., Methods: As part of a qualitative study, interviews of facility-based providers who had managed PPH following comprehensive PPH training were conducted between February and April 2014. Facilities were purposively sampled to represent a range of experience with UBT, facility size, and geography. Interviews continued until thematic saturation was achieved. Interview transcripts were analyzed for themes., Results: Overall, 68 providers from 29 facilities were interviewed, of whom 31 reported experience with UBT placement (25 midwives, 2 clinical officers, 4 medical officers). Qualitative analysis revealed several major themes. Providers used UBT appropriately within the PPH algorithm, although the timing and clinical severity of patients varied. UBT was most commonly used when bleeding was unresponsive to uterotonics, hysterectomy was unavailable, and referral times long. Providers reported that bleeding was arrested following UBT use in all except one patient, who had a suspected coagulopathy. Most providers described UBT as technically easy to use, although three described initial balloon displacement., Conclusion: UBT has been readily accepted by providers at all levels of training and is being incorporated into the existing PPH management algorithm in Kenya., (Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
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