POPPHI NASG Update

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POPPHINASG Update

• Suellen Miller, CNM, PhD
• Associate Professor
• Dept Ob/Gyn Reproductive Sciences
• UCSF

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Pilot Study Findings Promising

• 364 women, pre/post
• BJOG, GPHJ
• Clinically promising faster recovery, shorter
  time of oxygen deprivation, lower blood loss
• Statistically significant on PROXY indicators
• OUTCOMES OF INTEREST Mortality and Morbidity,
  not statistically significant

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Studies Nearing Completion

• Egypt Study
• Complete in June, 2 tertiary care facilities
• 432 controls, gt 500 cases
• Nigeria
• Data Collection Complete, 12 facilities
• 200 controls, 550 cases

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NIH/Gates RCT

• Collaboration UCSF, WHO/RHR, CREP, UTH, UZ
• Randomized Cluster Trial
• Zambia and Zimbabwe
• Application of NASG at midwifery-led peripheral
  clinics
• Transport to Tertiary Care Hospital
• Sample size large enough to demonstrate 50
  decrease in MM

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Haemodynamic Flow Study

• Felicia Lester and Juan Vargas, SFGH
• 10 newly postpartum women
• Doppler blood flow in uterine vessels with each
  segment of the NASG in place

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Post Abortion Hemorrhage Study

• Use of NASG for late post abortion hemorrhages
• Eleanor Drey, UCSF
• Rate of about one severe Post Ab Hemorrhage /
  month
• Pre/post
• Measure of blood loss, restoration of vital
  signs, time to recovery from shock while awaiting
  radiologic arterial embolization

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Diffusion of Innovation

• What factors encourage rapid diffusion of new
  technologies?
• Qualitative research

Community Awareness
Community Awareness
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Providers Delays
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Continuum of Care Project

• Pathfinder Implementing Agency
• 8 States in Nigeria
• 5 States in India
• Prophylaxis of PPH
• Early Identification
• of PPH
• Treatment with NASG
• Community Communication and Transportation
  Systems for Referral to Facilities capable of
  Emergency Obstetric Care
• Baseline Data Collection Underway
• Macarthur Foundation Funding

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• Thank you
• Questions
• suellenmiller_at_gmail.com