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External aortic compression

the problem

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One out of ten parturients world wide develop severe bleeding after delivery (>500 ml), referred to as postpartum haemorrhage.

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Postpartum heamorrhage is a potentially life treathening condition and requires emergency intervention.

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Established medical practices for treatment depend on cost-driving medicine and blood transfusion.

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Postpartum haemorrhage is the primary cause of maternal mortality.

the solution

External aortic compression is a simple maneuver where aorta is compressed against the spinal column to reduce bleeding.

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The blood vessels to the uterus originate below the compressed area and the bloodflow is effectively stopped.

Temporarily bleeding control at an early stage allows cause-oriented treatment without severe blood loss.

It inhibits escaltion of the bleeding and minimizes risks, the necessity for medication and blood transfusions, as well as the requirement for postpartum surgery and other complications.

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Ove Karlsson

 MD, PhD
Anaestesiologist with obstetric anesthesia as primary interest.

At the University Hospital in Gothenburg we implemented the use of early external aortic compression  in cases of major postpartum hemorrhage in 2009. External aortic compression has since then been the primary intervention for bleedings of more than 1 liter or even less if the bleeding is heavy.  We apply aortic compression prior to venous access.

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Maarten Glas 

Obstetrician and Gynaecologist,MSF Holland (OCA)

I discovered the logic and feasibility of aorta compression over twenty years ago and have used it countless times. Post partum hemorrhage simply is a compressible bleeding. I have worked in many low income countries with limited means and absent or little access to blood transfusion. It is a true life saver under these conditions.

I often use it from an early stage, when the bleeding is ongoing but the woman is not yet in shock. 

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Niclas Carlberg

Anaesthesiologist, Sahlgrenska university hospital, Östra, Göteborg Sweden

I remember how much parturient could have bled before arriving in the OR. They could be  circulatoric unstable with tachycardia and hypotension. During the last years this has changed, and bleeding parturients are now much more hemodynamically stable. The midwifes have become very quick to apply external aortic compression in the delivery room when they acknowledge abnormal postpartum bleeding.

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