Post-partum haemorrhage device to the rescue

Healthcare professionals, including obstetrics and gynaecologists, nurses, and midwives, have welcomed the introduction of a new medical device for managing postpartum haemorrhage (PPH) to reduce Ghana’s high maternal mortality rate.

The device – Ellavi Uterine Balloon Tamponade (UBT) – is a minimally invasive, easy to-to-use, and effective intervention for treating and managing severe PPH (postpartum bleeding), which is the leading direct cause of maternal mortality worldwide.

The method involves inserting the balloon-like end of the device into the uterus of the woman and then filling the balloon with water from a supply bag on the other end, through a tube regulated by a T-Valve, which applies pressure to the uterine until the bleeding stops.

The pre-assembled ellavi UBT is a product of SINAPI Biomedical Limited, a South African company.

It is ISO certified, registered, and approved by Ghana’s Food and Drugs Authority (FDA).

Dr Kofi Issa, the Director of the Family Health Division of the Ghana Health Service (GHS), at a dissemination meeting in Accra, said PPH was a major health concern in Ghana, and therefore, required appropriate emergency preparedness for improved results.

He described the device as a life-saving medical tool that could easily be used by trained maternal health care providers to prevent excessive bleeding in women during pregnancy, childbirth, and six weeks after delivery to save women from the needless deaths caused by PPH.

Dr Issa said the innovation would complement existing methods such as uterotonics (use of special medications), uterine massage, or bimanual compression followed by invasive surgical treatments, explaining that in most cases where those methods had failed, healthcare providers had very few other options.

He said the good news was that the device had been piloted in three key healthcare facilities – the Tema General Hospital, Greater Accra Regional Hospital, Ridge, and the then Kasoa Mother and Child Hospital (now Kasoa Polyclinic) – and had been proven to be a very effective intervention for treating post-partum bleeding.

The meeting will, among other things, discuss the cost of the device, policy changes, training, and supply or procurement issues.

Dr Issa explained that although pregnancy and childbirth were supposed to be happy occasions, some ended up in tragedy, which did not only affect individual families, but communities and the nation at large.

Maternal mortality is a key indicator for measuring the performance of a country’s population.

Dr Patience Cofie, the Country Director of PATH, an international NGO, said the breakthrough was achieved after her Organisation contacted SINAPI Biomedicals on the possibility of developing a pre-assembled, ready-to-use tamponade based on the recommendations of trainees from the GHS.

She said at a PATH training programme authorised by the GHS, several doctors, midwives, and nurses were made to assemble and use the condom catheter to resolve refractive PPH, but the trainees complained that the method took a lot of time.

However, testimonies from maternal healthcare providers trained in the various facilities involved in the ellavi UBT pilot study for the UBT had attested to the fact that effective tamponed occurred rapidly within five to 15 minutes after insertion and inflation of the balloon.

She explained that even in instances where UBT could not completely control severe PPH due to other complications such as rapture in the uterus, it served a critical role in reducing blood loss until the woman could be transported to a facility with surgical and other treatment options.

Dr Chris Opoku Fofie, who represented the Maternal Health and Safe Motherhood Programme, said Ghana’s maternal mortality ratio was at 308 per 100,000 live births, adding that most of the deaths occurred in the underserved health facilities across the country, hence the need to welcome such effective methods to address the gaps.