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. Since 2002, non-pneumatic anti-shock garment has been used in dozens of countries to save the lives of thousands of women, from the United States to South Africa. Across numerous clinical trials and pilot projects, the NASG has demonstrated a 40 to 80% reduction in maternal mortality.
Once in place, the Non-Pneumatic Anti-Shock Garment applies enough circumferential counter pressure to decrease blood loss and reverse shock by increasing blood pressure to the heart, brain, and lungs. In so doing, it reverses hypovolaemic shock resulting from Obstetric Haemorrhage, and has proven effective in stabilizing patients for up to 3 days, This allows enough time for patients to be transported to a health center with the ability to administer blood transfusions and provide definitive medical or surgical interventions.
An anti-shock garment applies circumferential counter pressure on the lower body and uterus which increases circulating blood to the heart, lungs and brain and decreases the rate of blood flow in the abdomen and pelvis, thus decreasing blood loss.
Ordering Info and How to Purchase Non-Pneumatic Anti-Shock Garments in Africa
How to Easily Order Anti-Shock Garments Online, Government Tenders & Bulk Orders
To order a NASG Garment please fill out an enquiry form and someone will be in touch with you shortly. We work with medical professionals, government offices, and medical distributors and importers to provide you with an excellent price. For larger procurement orders or government tenders for the NASG, please enquire about our quantity discounts, bulk purchasing and freight logistics offerings. The NASG Africa team is experienced in delivering the highest quality of ordering, payment and logistics services along with the guaranteed lowest price. The Partnership is the largest supplier of anti-shock garments to Africa and has experience working with ministries of health, regional and provincial governments, doctors, midwives, NGOs and more to improve the lives of mothers across Africa.
Locations Where You Can Get an Anti-Shock Garment for PPH in Africa
NASG-Africa is a partnership between VIA Global Health’s South African office and distributors of maternal health supplies across Africa dedicated to ensuring affordable and timely access to life-saving medical supplies. If you are interested in joining the NASG Africa distribution network please enquire here.
Within South Africa: Eastern Cape province, Free State province, Gauteng province, KwaZulu-Natal province, Limpopo province, Mpumalanga province, Northern Cape province, North West province, Western Cape province and more! Including the cities of Cape Town, Johannesburg, Durban, Soweto, Pretoria, Port Elizabeth, Pietermaritzburg, Benoni, Tembisa, East London and more.
Across Africa the NASG Africa Partnership Will Deliver to: Algeria, Angola, Benin, Botswana, Burkina Faso, Burundi, Cabo Verde, Cameroon, Central African Republic (CAR), Chad, Comoros, Democratic Republic of the Congo, Republic of the Congo, Cote d’Ivoire, Djibouti, Egypt, Equatorial Guinea, Eritrea, Eswatini (formerly Swaziland), Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Lesotho, Liberia, Libya, Madagascar, Malawi, Mali, Mauritania, Mauritius, Morocco, Mozambique, Namibia, Niger, Nigeria, Rwanda, Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, Somalia, South Africa, South Sudan, Sudan, Tanzania, Togo, Tunisia, Uganda, Zambia, Zimbabwe
Non-Pneumatic Anti-Shock Garment Use Cases
Anti-shock garments are typically used to treat postpartum or obstetric hemorrhage and hypovolemic shock in low resource settings, such as rural clinics or during home birth settings where access to uteronics, surgery and blood supply is limited. Numerous clinical trials around the world examining the use of the NASG have shown it to be effective in treating PPH.
The NASG is known to be effective for treating PPH resulting from uterine atony, uterine, cervical vaginal and perineum trauma, as well as thrombin, coagulopathy, tissue retention and placental abnormalities.
Video example of using an anti-shock garment to treat PPH.
When to initiate NASG application is dependent upon where in the healthcare delivery system the haemorrhage occurs, the attendants’ skills and capacity for blood transfusions and/or surgery. In lower-level facilities, or when women present in shock and with circulatory collapse, the NASG should be applied as the first step in resuscitation; application will fill blood vessels, enabling an IV to be started, or if there is no capacity for IV infusions, enhanced core organ perfusion.
How to Apply the NASG
Overall the Non-Pneumatic Anti-Shock garment is a simple and easy-to-use device for treating PPH. It requires relatively little training and can be applied quickly in cases of emergency. Once the mother’s bleeding has been controlled she can then be safely transported to a hospital for emergency obstetrical care.
Anti-shock Application Procedure:
Step 1: Open the NASG and place under the woman with the top of the garment at her lowest rib. If the patient is unconscious, two people can roll her onto her side placing the garment underneath her, similar to making an occupied bed.
Step 2: Stretch and fasten the garment tightly, starting with the ankle segments (#1) (Figure 2).
Step 3: Continue with #2 segments below the knee and #3 segments around the thighs; for shorter women, fold segment #1 into segment #2 before starting.
Step 4: Secure the pelvic segment (#4) tightly at the level of the symphysis pubis; only one person should secure the pelvic and abdominal segments.
Step 5: Place segment #5 over the umbilicus, close by securing segment #6
Additional Non-Pneumatic Anti-Shock Garment Application Assistance and Materials
The following NASG Job Aids developed by the Safe Motherhood Program at UCSF are available for you to download and print.
Below is a fifteen minute NASG Training video by the Safe Motherhood Program at UCSF narrated by Dr. Suellen Miller.
How and When to Safely Remove an Anti-Shock Garment
The NASG must be removed only under skilled supervision in a setting where vital signs can be monitored and there are adequate IV fluids. It should not be removed until the woman has been haemodynamically stable for at least 2 hours with blood loss 50 mL/hour, pulse 100 BPM and SBP 100 mm Hg. To safely remove the garment, start with the ankle segments and proceed upwards. Allow 15 minutes between opening each segment for the redistribution of blood, then check vital signs.
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 & 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.
Non-Pneumatic Anti-Shock Garment Product Documents
Anti-Shock Garment Warranty
The NASG Africa garment carries a factory warranty of up to 2 years for manufacturing issues and the device has been wear tested up to 144 uses by Intertek.
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.