For Practioners: Device Solution for PPH Treatment
Salt Creek International Women’s Health Foundation developed a novel medical device (a paracervical clamp set) to address one of the gravest of challenges to women’s health on the global scale: postpartum hemorrhage (PPH). This technology is specifically designed and developed for application in resource-poor communities of developing countries. We endeavor to transform PPH treatment and prevention measures by equipping health care providers with a simple, safe, and effective tool that can enable safe births for all women regardless of financial, geographic, or resource barriers.
The Problem: Preventive measures against PPH are part of good clinical practice during active management of the third stage of labor (AMTSL). Most important in AMTSL is the administration of a uterotonic (e.g. Misoprostol, ergometrine, or oxytocin) after the delivery of the baby. This step in AMTSL is critical; however, drug treatments are not 100% effective. There are times when these drugs fail, as well as situations in which drug administration is not feasible. Drugs can represent costly expenses over time, require strong supply chains, and sometimes necessitate refrigeration, which requires sufficient resource availability. There remains critical need for an additional method of treatment that will help fill the current gaps in PPH management and treatment.
Our Solution: To treat PPH in low-resource health care settings, the Salt Creek International Women’s Health Foundation developed a low-tech, reusable, portable, and affordable set of stainless steel paracervical clamps. We anticipate that the device may be used in any birthing setting – facility or non-facility – to significantly decrease and/or stop blood loss. These specially-shaped clamps are used by entering through the vagina to reach and temporarily close the uterine arteries against the uterine wall (after the baby is born). Occlusion of these arteries, which represent the source of 90% of blood flowing to the uterus, instantaneously reduces or stops PPH. If applied before the separation and expulsion of the placenta, uterine artery occlusion may also create a clotting cascade along the uterine wall that would allow the placenta to detach with greater ease. The device achieves results similar to surgical procedures used in high income countries to treat PPH; however, it achieves these results through a minimally invasive and simplified, transvaginal application. As the location of the uterine arteries is almost universally the same in every woman at term, it is reasonable to anticipate that once trained to apply the device, health care providers of varied levels of medical education and training backgrounds could use it safely and effectively in any delivery setting to treat PPH.