October 21, 2015

A balloon to save moms’ lives

This post originally appeared on PATH’s website.

PATH helped develop a simple tool that could save the lives of 169,000 women over the next 15 years. And yes, it involves a balloon.

8 p.m. in a village clinic in Western Kenya
It’s dark out when the young woman arrives in labor. With the help of the clinic midwife, Motari, she delivers a healthy baby. There is that moment of joy. And then, things start to go wrong. The mother begins to bleed—profusely—and does not stop.

Motari works furiously, administering drugs, massaging the uterus. But the bleeding still does not stop. The mother’s blood pressure is dropping, and she’s going into shock. She could die any minute.

Unpredictable and unfair
This is postpartum hemorrhage. It kills about 130,000 women every year, the vast majority in sub-Saharan Africa and India. These women are vulnerable because the health facilities where they give birth don’t have emergency obstetric care, such as blood transfusions or surgeons that hospitals in wealthy countries have at the ready.

“Postpartum hemorrhage is very unpredictable,” says Elizabeth Abu-Haydar, a public health specialist at PATH who looks for ways that technology can make childbirth safer. “It can happen in a flash to any woman giving birth.”

Still, she says, “No woman should die from postpartum hemorrhage. It’s treatable.”

A balloon to the rescue
That conviction has driven Elizabeth to champion a simple device with a complicated name: the uterine balloon tamponade, or UBT for short.

The UBT is standard in wealthy countries, but with a price tag of nearly $400 for a single use, it’s far too expensive for low-resource settings. Looking for a more affordable solution, Elizabeth learned that a team at Massachusetts General Hospital had created a simple kit, called Every Second Matters (ESM-UBT).

Assembled with items that can be found in a clinic, the kit costs one-tenth of the commercial UBT. It includes a condom (the “balloon”), which is filled with water using a syringe and rubber tubing. The water-filled balloon exerts pressure on the walls of the uterus, creating a tamponade that stops the flow of blood.

PATH is working with Mass General to ensure the device can be easily and safely used by nurses and midwives and to accelerate its introduction in rural and underserved communities. The ESM-UBT kit has been introduced in 149 clinics in Western Kenya that are part of PATH’s APHIAplus project.

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