Cost‐effectiveness of uterine tamponade devices for the treatment of postpartum hemorrhage: A systematic review

Vogel, Joshua P.; Wilson, Alyce N.; Scott, Nick; Widmer, Mariana; Althabe, Fernando; Oladapo, Olufemi T.

doi:10.1002/ijgo.13393

Cited by 10 publications

(6 citation statements)

References 28 publications

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“…Many researchers have developed PPH care bundles, but there has been limited evidence to demonstrate which, if any, bundles lead to improved outcomes. Vogel et al conducted a systematic review to identify which care bundles were safe and effective for the prevention and treatment of PPH 6 . They registered their protocol with the International Prospective Register of Systematic Reviews and followed the Preferred Reporting Items of Systematic Reviews and Meta‐Analyses guidance for reviews of complex interventions.…”

Section: Are Care Bundles the Solution To The Diagnosis And Managemen...mentioning

confidence: 99%

Systematic Reviews to Inform Practice, May/June, 2024

Howe‐Heyman

2024

J Midwife Womens Health

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Section: Are Care Bundles the Solution To The Diagnosis And Managemen...mentioning

confidence: 99%

Systematic Reviews to Inform Practice, May/June, 2024

Howe‐Heyman

2024

J Midwife Womens Health

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“…An example is uterine balloon tamponade, which was made available globally in a short period of time, because balloons could be easily made from a condom and a catheter, as opposed to the time-consuming processes of registration and distribution of purpose-designed devices. The cost of uterine tamponade devices ranges from USD 0.64 to USD 400 [ 35 ].…”

Section: Novel Approaches To Uterine Balloon Tamponadementioning

confidence: 99%

Novel concepts and improvisation for treating postpartum haemorrhage: a narrative review of emerging techniques

Hofmeyr¹

2023

Reprod Health

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Background Most treatments for postpartum haemorrhage (PPH) lack evidence of effectiveness. New innovations are ubiquitous but have not been synthesized for ready access. Narrative review Pubmed 2020 to 2021 was searched on ‘postpartum haemorrhage treatment’, and novel reports among 755 citations were catalogued. New health care strategies included early diagnosis with a bundled first response and home-based treatment of PPH. A calibrated postpartum blood monitoring tray has been described. Oxytocin is more effective than misoprostol; addition of misoprostol to oxytocin does not improve treatment. Heat stable carbetocin has not been assessed for treatment. A thermostable microneedle oxytocin patch has been developed. Intravenous tranexamic acid reduces mortality but deaths have been reported from inadvertent intrathecal injection. New transvaginal uterine artery clamps have been described. Novel approaches to uterine balloon tamponade include improvised and purpose-designed free-flow (as opposed to fixed volume) devices and vaginal balloon tamponade. Uterine suction tamponade methods include purpose-designed and improvised devices. Restrictive fluid resuscitation, massive transfusion protocols, fibrinogen use, early cryopreciptate transfusion and point-of-care viscoelastic haemostatic assay-guided blood product transfusion have been reported. Pelvic artery embolization and endovascular balloon occlusion of the aorta and pelvic arteries are used where available. External aortic compression and direct compression of the aorta during laparotomy or aortic clamping (such as with the Paily clamp) are alternatives. Transvaginal haemostatic ligation and compression sutures, placental site sutures and a variety of novel compression sutures have been reported. These include Esike’s technique, three vertical compression sutures, vertical plus horizontal compression sutures, parallel loop binding compression sutures, uterine isthmus vertical compression sutures, isthmic circumferential suture, circumferential compression sutures with intrauterine balloon, King’s combined uterine suture and removable retropubic uterine compression suture. Innovative measures for placenta accreta spectrum include a lower uterine folding suture, a modified cervical inversion technique, bilateral uterine artery ligation with myometrial excision of the adherent placenta and cervico-isthmic sutures or a T-shaped lower segment repair. Technological advances include cell salvage, high frequency focussed ultrasound for placenta increta and extra-corporeal membrane oxygenation. Conclusions Knowledge of innovative methods can equip clinicians with last-resort options when faced with haemorrhage unresponsive to conventional methods.

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“…Comparison with other reviews of economic evaluations in maternal health similarly found that research in this area has increased. Previous reviews typically had a narrower focus, including studies focused on a single or specific set of interventions or evidence from specific settings [9][10][11][12][13][14] , and consequently identified a smaller number of eligible studies (typically less than 30). For example, a 2018 systematic review of health systems strengthening economic evaluations in maternal and perinatal health identified 24 eligible studies, 23 of which were published since 2000 13 .…”

Section: Key Findings and Interpretationmentioning

confidence: 99%

“…The 2016 Disease Control Priorities summarised cost-effectiveness evidence for selected, high-value maternal interventions, identifying 26 studies 10 . More recently, systematic reviews of economic evaluations have been conducted for single interventions as part of WHO recommendation updates 11,12 . Other reviews have focused on economic evaluations of certain categories of interventions in LMICs, such as health systems strengthening strategies, or programs to increase utilisation and provision of care 13,14 .…”

Section: Introductionmentioning

confidence: 99%

Economic evaluations of maternal health interventions: a scoping review

et al. 2022

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Background Evidence on the affordability and cost-effectiveness of interventions is critical to decision-making for clinical practice guidelines and development of national health policies. This study aimed to develop a repository of primary economic evaluations to support global maternal health guideline development and provide insights into the body of research conducted in this field. Methods A scoping review was conducted to identify and map available economic evaluations of maternal health interventions. We searched six databases (NHS Economic Evaluation Database, EconLit, PubMed, Embase, CINAHL and PsycInfo) on 20 November 2020 with no date, setting or language restrictions. Two authors assessed eligibility and extracted data independently. Included studies were categorised by subpopulation of women, level of care, intervention type, mechanism, and period, economic evaluation type and perspective, and whether the intervention is currently recommended by the World Health Organization. Frequency analysis was used to determine prevalence of parameters. Results In total 923 studies conducted in 72 countries were included. Most studies were conducted in high-income country settings (71.8%). Over half pertained to a general population of pregnant women, with the remainder focused on specific subgroups, such as women with preterm birth (6.2%) or those undergoing caesarean section (5.5%). The most common interventions of interest related to non-obstetric infections (23.9%), labour and childbirth care (17.0%), and obstetric complications (15.7%). Few studies addressed the major causes of maternal deaths globally. Over a third (36.5%) of studies were cost-utility analyses, 1.4% were cost-benefit analyses and the remainder were cost-effectiveness analyses. Conclusions This review provides a navigable, consolidated resource of economic evaluations in maternal health. We identified a clear evidence gap regarding economic evaluations of maternal health interventions in low- and middle-income countries. Future economic research should focus on interventions to address major drivers of maternal morbidity and mortality in these settings.

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Cost‐effectiveness of uterine tamponade devices for the treatment of postpartum hemorrhage: A systematic review

Cited by 10 publications

References 28 publications

Systematic Reviews to Inform Practice, May/June, 2024

Systematic Reviews to Inform Practice, May/June, 2024

Novel concepts and improvisation for treating postpartum haemorrhage: a narrative review of emerging techniques

Economic evaluations of maternal health interventions: a scoping review

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