{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T10:34:11Z","timestamp":1774262051107,"version":"3.50.1"},"reference-count":14,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2015,7,21]],"date-time":"2015-07-21T00:00:00Z","timestamp":1437436800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005945","name":"Izumi Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005945","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the effectiveness and safety of an ultra\u2010low\u2010cost uterine balloon tamponade package (<jats:styled-content style=\"fixed-case\">ESM<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">UBT<\/jats:styled-content>\u2122) for facility\u2010based management of uncontrolled postpartum haemorrhage (<jats:styled-content style=\"fixed-case\">PPH<\/jats:styled-content>) in Kenya, Sierra Leone, Senegal, and Nepal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective multi\u2010centre case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Facilities in resource\u2010scarce areas of Kenya, Sierra Leone, Nepal, and Senegal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Women with uncontrolled postpartum haemorrhage in 307 facilities across the four countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A standardised <jats:styled-content style=\"fixed-case\">ESM<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">UBT<\/jats:styled-content> package was implemented in 307 facilities over 29\u00a0months (1 September 2012 to 1 February 2015). Data were collected via a multi\u2010pronged approach including data card completion, chart reviews, and provider interviews. Beginning in August 2014, women who had previously undergone <jats:styled-content style=\"fixed-case\">UBT<\/jats:styled-content> placement were sought and queried regarding potential complications associated with <jats:styled-content style=\"fixed-case\">UBT<\/jats:styled-content> use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>All\u2010cause survival, survival from <jats:styled-content style=\"fixed-case\">PPH<\/jats:styled-content>, and post\u2010<jats:styled-content style=\"fixed-case\">UBT<\/jats:styled-content> use complications (surgery, hospitalisation, antibiotics for pelvic infection) associated with <jats:styled-content style=\"fixed-case\">UBT<\/jats:styled-content> use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>201 <jats:styled-content style=\"fixed-case\">UBT<\/jats:styled-content>s were placed for uncontrolled vaginal haemorrhage refractory to all other interventions. In all, 38% (71\/188) of women were either unconscious or confused at the time of <jats:styled-content style=\"fixed-case\">UBT<\/jats:styled-content> insertion. All\u2010cause survival was 95% (190\/201). However, 98% (160\/163) of women survived uncontrolled <jats:styled-content style=\"fixed-case\">PPH<\/jats:styled-content> if delivery occurred at an <jats:styled-content style=\"fixed-case\">ESM<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">UBT<\/jats:styled-content> online facility. One (1\/151) potential <jats:styled-content style=\"fixed-case\">UBT<\/jats:styled-content>\u2010associated complication (postpartum endometritis) was identified and two improvised <jats:styled-content style=\"fixed-case\">UBT<\/jats:styled-content>s were placed in women with a ruptured uterus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These pilot data suggest that the <jats:styled-content style=\"fixed-case\">ESM<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">UBT<\/jats:styled-content> package is a clinically promising and safe method to arrest uncontrolled postpartum haemorrhage and save women's lives. The <jats:styled-content style=\"fixed-case\">UBT<\/jats:styled-content> was successfully placed by all levels of facility\u2010based providers. Future studies are needed to further evaluate the effectiveness of <jats:styled-content style=\"fixed-case\">ESM<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">UBT<\/jats:styled-content> in low\u2010resource settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Evidence for <jats:styled-content style=\"fixed-case\">ESM<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">UBT<\/jats:styled-content> as a clinically promising and safe method to arrest uncontrolled <jats:styled-content style=\"fixed-case\">PPH<\/jats:styled-content> and save women's lives.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.13550","type":"journal-article","created":{"date-parts":[[2015,7,30]],"date-time":"2015-07-30T10:26:58Z","timestamp":1438252018000},"page":"1532-1540","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["A postpartum haemorrhage package with condom uterine balloon tamponade: a prospective multi\u2010centre case series in Kenya, Sierra Leone, Senegal, and Nepal"],"prefix":"10.1111","volume":"123","author":[{"given":"TF","family":"Burke","sequence":"first","affiliation":[{"name":"Division of Global Health and Human Rights Department of Emergency Medicine Massachusetts General Hospital Boston MA USA"},{"name":"Harvard Medical School Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Ahn","sequence":"additional","affiliation":[{"name":"Division of Global Health and Human Rights Department of Emergency Medicine Massachusetts General Hospital Boston MA USA"},{"name":"Harvard Medical School Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"BD","family":"Nelson","sequence":"additional","affiliation":[{"name":"Division of Global Health and Human Rights Department of Emergency Medicine Massachusetts General Hospital Boston MA USA"},{"name":"Harvard Medical School Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Hines","sequence":"additional","affiliation":[{"name":"Division of Global Health and Human Rights Department of Emergency Medicine Massachusetts General Hospital Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Kamara","sequence":"additional","affiliation":[{"name":"Division of Global Health and Human Rights Department of Emergency Medicine Massachusetts General Hospital Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Oguttu","sequence":"additional","affiliation":[{"name":"Kisumu Medical and Education Trust Kisumu Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"Dulo","sequence":"additional","affiliation":[{"name":"Kisumu Medical and Education Trust Kisumu Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Achieng","sequence":"additional","affiliation":[{"name":"Kisumu Medical and Education Trust Kisumu Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B","family":"Achieng","sequence":"additional","affiliation":[{"name":"Kisumu Medical and Education Trust Kisumu Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Natarajan","sequence":"additional","affiliation":[{"name":"Division of Global Health and Human Rights Department of Emergency Medicine Massachusetts General Hospital Boston MA USA"},{"name":"Harvard Medical School Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Maua","sequence":"additional","affiliation":[{"name":"Division of Reproductive and Maternal Health Ministry of Health Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SAS","family":"Kargbo","sequence":"additional","affiliation":[{"name":"Division of Reproductive Health Ministry of Health and Sanitation Freetown Sierra Leone"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Z","family":"Altawil","sequence":"additional","affiliation":[{"name":"Division of Global Health and Human Rights Department of Emergency Medicine Massachusetts General Hospital Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Tester","sequence":"additional","affiliation":[{"name":"Division of Global Health and Human Rights Department of Emergency Medicine Massachusetts General Hospital Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"de Redon","sequence":"additional","affiliation":[{"name":"Division of Global Health and Human Rights Department of Emergency Medicine Massachusetts General Hospital Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Niang","sequence":"additional","affiliation":[{"name":"Centre de Formation et de Recherche en Sant\u00e9 de la Reproduction Dakar Senegal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Abdalla","sequence":"additional","affiliation":[{"name":"UNICEF Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MJ","family":"Eckardt","sequence":"additional","affiliation":[{"name":"Division of Global Health and Human Rights Department of Emergency Medicine Massachusetts General Hospital Boston MA USA"},{"name":"Department of Obstetrics and Gynecology Boston Medical Center Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,7,21]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"WHO Guidelines Approved by the Guidelines Review Committee","author":"WHO Recommendations for the Prevention and Treatment of Postpartum Haemorrhage","year":"2012"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/bmb\/ldg015"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68397-9"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2011.04.018"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.12404"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.09.015"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2013.08.010"},{"key":"e_1_2_11_9_1","volume-title":"A Comprehensive Textbook of Postpartum Hemorrhage: An Essential Clinical Reference for Effective Management","author":"Arulkumaran S","year":"2012"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ogx.0000271137.81361.93"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2013.02.017"},{"key":"e_1_2_11_12_1","volume-title":"WHO Guidelines for the Management of Postpartum Haemorrhage and Retained Placenta","author":"G\u00fclmezoglu AM","year":"2009"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2005.03.018"},{"key":"e_1_2_11_14_1","first-page":"1039","article-title":"ACOG Practice Bulletin: Clinical Management Guidelines for Obstetrician\u2010Gynecologists, Number 76, October 2006: postpartum hemorrhage","volume":"108","author":"Obstetricians ACo, Gynecologists","year":"2006","journal-title":"Obstet Gynecol"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2012.03454.x"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1471-0528.13550","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1471-0528.13550","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.13550","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1471-0528.13550","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.13550","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T18:26:05Z","timestamp":1696357565000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.13550"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,7,21]]},"references-count":14,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2016,8]]}},"alternative-id":["10.1111\/1471-0528.13550"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.13550","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,7,21]]},"assertion":[{"value":"2015-06-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-07-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}