“The NASG is a true life-saving device for women in shock and close to death due to PPH. This is a major life-saving support device, easy to administer by any health personnel and needs to be available for pregnant women everywhere and particularly in low resource countries.”
The Non-Pneumatic Anti-Shock Garment is a washable and reusable first aid device to treat Postpartum Haemorrhage (PPH). The NASG is light, flexible and comfortable for the wearer and does not need to be removed for uterine massage, examinations or vaginal procedures.
In partnership with the largest global distributor of maternal supplies to emerging markets, NASG-Africa’s network of local distribution partners across Africa makes it easy for people across the continent to order quantities from 1 to 5,000 and at the guaranteed lowest price you will find.
Live Webinar Thursday, March 14th at 3pm (SAST)
Early lessons learned from the use of Non-Pneumatic Anti-Shock Garment (NASG) in Kwazulu-Natal Region 4
Postpartum Haemorrhage Background
Postpartum haemorrhage (PPH) is excessive bleeding following delivery of a baby and is the most common cause of maternal death worldwide. In sub-Saharan Africa it is the leading cause of maternal mortality. About 20% of women experience some form of postpartum haemorrhage following birth. According to Stanford Children’s Hospital, PPH is commonly defined as blood loss of 500 ml or more within 24 hours after birth, while severe PPH is defined as blood loss of 1000 ml or more within the same timeframe according to World Health Organisation (WHO). For women who are anemic, and a large number of women across Africa are anemic, PPH is a life-threatening condition.
Several leaders in the global health community including USAID, the Gates Foundation, the Safe Motherhood Program at UCSF and VIA Global Health have dedicated significant resources to expanded awareness and adoption of the NASG worldwide.
Development of Anti-Shock Garment for PPH
The anti-shock garment was originally developed by George Crile as an inflatable pressure suit to maintain blood pressure during surgery. During the 1970s this morphed into military anti-shock trousers, a compression garment used to treat soldiers on the battlefield in shock. The first use in obstetric settings began in 2002 when Dr. Paul Hensleigh and Carol Brees began using the garment in a hospital in Pakistan. Following that introduction, Dr. Suellen Miller, along with her colleagues from the University of California San Francisco’s Bixby Center for Global Reproductive Health, initiated multiple studies of the Non-pneumatic Anti-Shock Garment (NASG) for the management of obstetric haemorrhage around the world.
Causes of Postpartum Haemorrhage
According to a 2007 study the most common causes of postpartum haemorrhage are uterine atony, trauma, retained placenta or placental abnormalities and coagulopathy.
- Tone: uterine atony is the inability of the uterus to contract and may lead to continuous bleeding. Retained placental tissue and infection may contribute to uterine atony. Uterine atony is the most common cause of postpartum hemorrhage.
- Trauma: Injury to the birth canal which includes the uterus, cervix, vagina and the perineum which can happen even if the delivery is monitored properly. The bleeding is substantial as all these organs become more vascular during pregnancy.
- Tissue: retention of tissue from the placenta or fetus as well as placental abnormalities such as placenta accreta and percreta may lead to bleeding.
- Thrombin: a bleeding disorder occurs when there is a failure of clotting, such as with diseases known as coagulopathies.
Additionally, according to the Children’s Hospital of Philadelphia the causes of postpartum haemorrhage can vary widely. Some of the most common include:
- Placental abruption. The early detachment of the placenta from the uterus.
- Placenta previa. The placenta covers or is near the cervical opening.
- Overdistended uterus. Excessive enlargement of the uterus due to too much amniotic fluid or a large baby, especially with birth weight over 4,000 grams (8.8 pounds).
- Multiple pregnancy. More than one placenta and overdistention of the uterus.
- Gestational hypertension or preeclampsia. High blood pressure of pregnancy.
- Having many previous births
- Prolonged labor
- Medications to induce labor
- Medications to stop contractions (for preterm labor)
- Use of forceps or vacuum-assisted delivery
- General anesthesia
Peer Reviewed Scientific Publications on PPH and NASG
Provided for your convenience on behalf of the Safe Motherhood Program at UCSF.
Anti-shock garment in postpartum haemorrhage. Miller, S; Martin, H; Morris JL. Best Practice and Research in Clinical Obstetrics and Gynaecology, August 2008, 22(6) 1057-74.
Impact of nonpneumatic antishock garment in the management of patients with hypoperfusion due to massive postpartum hemorrhage. Escobar M, Fernández P, Carvajal J, Burgos J, Messa A, Echavarria M, Nieto A, Montes D, Miller S, Hurtado D. (2019) J Matern Fetal Neonatal Med. 2019 Jan 11:1-171.
Implementation project of the non-pneumatic anti-shock garment and m-communication to enhance maternal health care in rural Tanzania. Mbaruku G, Skaer Therrien M, Tillya R, Mbuyita S, Mtema Z, Kinyonge I, Godfrey R, Temu S and Miller S. (2018) Reproductive Health 15(1):177.
Experience in the use of non-pneumatic anti-shock garment (NASG) in the management of postpartum haemorrhage with hypovolemic shock in the Fundación Valle Del Lili, Cali, Colombia. Escobar MF, Füchtner CE, Carvajal JA, Nieto AJ, Messa A, Escobar SS, Monroy AM, Forero AM, Casallas JD, Granados M, Miller S. (2017) Reproductive Health 14:58.