Reducing maternal death is the fifth Millennium Developmental Goal as Identified by the World Health Organisation (WHO) and has been a priority in Africa for many years. In Africa, the maternal mortality rate is still unacceptably high – one woman dies every 7 minutes in Africa from birth-complications. The leading cause of maternal death is post-partum haemorrhage (PPH) accounting for up to 35% of cases. In Sub-Saharan Africa, approximately 1 in 10 mothers will suffer from post-partum haemorrhage. The WHO guidelines for the management of PPH can be found here. In addition to administering oxytocin, tranexamic acid and other conservative management strategies, a recommendation is made to place an intra-uterine tamponade balloon in cases of uncontrolled haemorrhage until specialist care may be accessed. Yet, commercial tamponade devices, such as the Bakri Balloon may not be cost-effective and feasible within the resource-limited settings of Africa. These may cost up to $250! This problem is compounded when considering the relative shortage of blood and the geographical hurdles to overcome in order to access specialist gynaecological care. These devices may be welcome temporising measures that prevent massive haemorrhage during transfer to these facilities. So, what is the #AS2AP? (African Solution to African Problems)
Who would have thought that the very device that may prevent pregnancy, may also prevent death from delivery? Above is a novel African innovation that employs low cost equipment to effect uterine tamponade.