scholarly journals O Papel da Ocitocina na Profilaxia da Hemorragia Pós-Parto em Locais com Recursos Limitados

2021 ◽  
Vol 34 (13) ◽  
Author(s):  
Inês Ferreira ◽  
Ana Reynolds
Keyword(s):  
Postpartum Hemorrhage ◽  
Healthcare Professionals ◽  
Cultural Barriers ◽  
Low Resource Settings ◽  
Low Resource ◽  
Widespread Access ◽  
Political Economic ◽  
Demand For Health ◽  
Cultural Constraints

Introduction: Postpartum hemorrhage remains one of the leading causes of maternal death globally. Oxytocin is the uterotonic agent of choice for the prophylaxis of this complication. However, its use in low-resource settings is associated with clinical, political, economic and cultural constraints. The goal of this article is to describe the use of oxytocin for postpartum hemorrhage prophylaxis in low-resource settings.Material and Methods: A literature review on the topic was carried out, and 24 articles were included.Results: The information was organized into seven sections: the evaluation of the efficacy of oxytocin compared to other uterotonics, the use of oxytocin in home births, the training of healthcare professionals, the quality of the available oxytocin, the new formulations, the risks associated with the use of uterotonic and the adopted health policies.Discussion: Despite the progress achieved widespread access to oxytocin for postpartum hemorrhage prophylaxis in low-resource settings is less than desirable. The main difficulties encountered were the shortage of skilled healthcare professionals for oxytocin administration, deficiencies concerning the quality of the drug and the inadequacy of available clinical guidelines.Conclusion: In order to reduce maternal mortality caused by postpartum hemorrhage in low-resource settings, it is essential to improve the knowledge of healthcare professionals, to implement good practices on the use of uterotonics, to optimize resource management and to overcome cultural barriers that prevent the demand for health services.

scholarly journals Does service integration improve technical quality of care in low-resource settings? An evaluation of a model integrating HIV care into family planning services in Kenya

2017 ◽  
Vol 32 (suppl_4) ◽  
pp. iv91-iv101 ◽  
Author(s):  
Richard Mutemwa ◽  
Susannah H Mayhew ◽  
Charlotte E Warren ◽  
Timothy Abuya ◽  
Charity Ndwiga ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Family Planning ◽  
Service Integration ◽  
Hiv Care ◽  
Technical Quality ◽  
Family Planning Services ◽  
Low Resource Settings ◽  
Low Resource

Improved Treatment of Postpartum Hemorrhage: Design, Development, and Bench-Top Validation of a Reusable Intrauterine Tamponade Device for Low-Resource Settings

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Katherine Hu ◽  
Maya M. Lapinski ◽  
Gavin Mischler ◽  
Robert H. Allen ◽  
Amir Manbachi ◽  
...  
Keyword(s):  
Postpartum Hemorrhage ◽  
Low Cost ◽  
Clinical Settings ◽  
Design Development ◽  
Low Resource Settings ◽  
Low Resource ◽  
Effective Interventions ◽  
Target Pressure ◽  
The Mean ◽  
Uterine Balloon Tamponade

Abstract Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide, and effective interventions for addressing PPH are urgently needed. Uterine balloon tamponade (UBT) is a technique to control PPH. Commercially available UBT devices are expensive and frequently require imaging technology to ensure placement. Condom-catheter uterine tamponade (C-UBT) is a technique appropriate for low-resource settings. Testing of the C-UBT is needed to better understand and optimize this technique for use in a variety of clinical settings including low-resource contexts. We describe here the design, development, and bench-top validation of a reusable C-UBT device optimized for low-resource settings. The device was tested in three differently sized uterine models using a variety of condom balloon configurations. Intrauterine wall pressure application was measured to evaluate the device capacity to apply pressure of at least 90 mmHg, estimating the mean arterial pressure within the uterine vasculature. Bench-top experimental validation of pressure exerted in uterine models demonstrated the device's capability of reaching hemostatic pressure in uterine volumes ranging from 170 to 1740 mL. Device adaptability and versatility were shown through its ability to reach the target pressure of 90 mmHg in different uterine sizes by varying balloon parameters, including condom thickness and condom configuration. The results of this study show the potential of a low-cost, reusable C-UBT device optimized to treat PPH in a variety of clinical settings, including low-resource contexts.

Validation of manual blood culture bottles  v2

2021 ◽  
Author(s):  
Sien Ombelet ◽  
Liselotte Hardy ◽  
Jan Jacobs
Keyword(s):  
Blood Culture ◽  
Blood Cultures ◽  
Automated System ◽  
Low Resource Settings ◽  
Low Resource ◽  
System P ◽  
Acceptable Quality ◽  
Personal Experiences ◽  
Laboratory Protocol

Use of equipment-free, “manual” blood cultures is still widespread in low-resource settings, as requirements for implementation of automated systems are often not met. Quality of manual blood culture bottles currently on the market, however, is usually unknown. An acceptable quality in terms of yield and speed of growth can be ensured by evaluating the bottles using simulated blood cultures. In these experiments, bottles from different systems are inoculated in parallel with blood and a known quantity of bacteria. Based on literature review and personal experiences, we propose a short and practical protocol for an efficient evaluation of manual blood culture bottles, aimed at research or reference laboratories in low-resource settings. This laboratory protocol was used in a study for Médecins Sans Frontières' Mini-Lab project, which aims to bring clinical bacteriology to low-resource settings. Three bottle types were evaluated in this study; two "manual" blood culture bottles and one automated system.

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