Healthcare providers experiences of using uterine balloon tamponade (UBT) devices for the treatment of post-partum haemorrhage: A meta-synthesis of qualitative studies.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2021
2021
Historique:
received:
30
09
2020
accepted:
02
03
2021
entrez:
18
3
2021
pubmed:
19
3
2021
medline:
13
10
2021
Statut:
epublish
Résumé
Postpartum haemorrhage (PPH) is a leading cause of maternal mortality and severe morbidity globally. When PPH cannot be controlled using standard medical treatments, uterine balloon tamponade (UBT) may be used to arrest bleeding. While UBT is used by healthcare providers in hospital settings internationally, their views and experiences have not been systematically explored. The aim of this review is to identify, appraise and synthesize available evidence about the views and experiences of healthcare providers using UBT to treat PPH. Using a pre-determined search strategy, we searched MEDLINE, CINAHL, PsycINFO, EMBASE, LILACS, AJOL, and reference lists of eligible studies published 1996-2019, reporting qualitative data on the views and experiences of health professionals using UBT to treat PPH. Author findings were extracted and synthesised using techniques derived from thematic synthesis and confidence in the findings was assessed using GRADE-CERQual. Out of 89 studies we identified 5 that met our inclusion criteria. The studies were conducted in five low- and middle-income countries (LMICs) in Africa and reported on the use of simple UBT devices for the treatment of PPH. A variety of cadres (including midwives, medical officers and clinical officers) had experience with using UBTs and found them to be effective, convenient, easy to assemble and relatively inexpensive. Providers also suggested regular, hands-on training was necessary to maintain skills and highlighted the importance of community engagement in successful implementation. Providers felt that administration of a simple UBT device offered a practical and cost-effective approach to the treatment of uncontrolled PPH, especially in contexts where uterotonics were ineffective or unavailable or where access to surgery was not possible. The findings are limited by the relatively small number of studies contributing to the review and further research in other contexts is required to address wider acceptability and feasibility issues.
Sections du résumé
BACKGROUND
Postpartum haemorrhage (PPH) is a leading cause of maternal mortality and severe morbidity globally. When PPH cannot be controlled using standard medical treatments, uterine balloon tamponade (UBT) may be used to arrest bleeding. While UBT is used by healthcare providers in hospital settings internationally, their views and experiences have not been systematically explored. The aim of this review is to identify, appraise and synthesize available evidence about the views and experiences of healthcare providers using UBT to treat PPH.
METHODS
Using a pre-determined search strategy, we searched MEDLINE, CINAHL, PsycINFO, EMBASE, LILACS, AJOL, and reference lists of eligible studies published 1996-2019, reporting qualitative data on the views and experiences of health professionals using UBT to treat PPH. Author findings were extracted and synthesised using techniques derived from thematic synthesis and confidence in the findings was assessed using GRADE-CERQual.
RESULTS
Out of 89 studies we identified 5 that met our inclusion criteria. The studies were conducted in five low- and middle-income countries (LMICs) in Africa and reported on the use of simple UBT devices for the treatment of PPH. A variety of cadres (including midwives, medical officers and clinical officers) had experience with using UBTs and found them to be effective, convenient, easy to assemble and relatively inexpensive. Providers also suggested regular, hands-on training was necessary to maintain skills and highlighted the importance of community engagement in successful implementation.
CONCLUSIONS
Providers felt that administration of a simple UBT device offered a practical and cost-effective approach to the treatment of uncontrolled PPH, especially in contexts where uterotonics were ineffective or unavailable or where access to surgery was not possible. The findings are limited by the relatively small number of studies contributing to the review and further research in other contexts is required to address wider acceptability and feasibility issues.
Identifiants
pubmed: 33735300
doi: 10.1371/journal.pone.0248656
pii: PONE-D-20-30548
pmc: PMC7971480
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0248656Subventions
Organisme : World Health Organization
ID : 001
Pays : International
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Int J Gynaecol Obstet. 2020 Mar;148(3):290-299
pubmed: 31709527
Obstet Gynecol. 2014 Jul;124(1):150-153
pubmed: 24901267
Int J Gynaecol Obstet. 2013 Jul;122(1):27-32
pubmed: 23623587
BMC Pregnancy Childbirth. 2018 Feb 6;18(1):47
pubmed: 29409456
Midwifery. 2006 Jun;22(2):108-19
pubmed: 16243416
Int J Gynaecol Obstet. 2015 Nov;131(2):201-4
pubmed: 26277599
BJOG. 2015 Jan;122(2):202-10
pubmed: 25289730
PLoS One. 2019 May 8;14(5):e0215919
pubmed: 31067245
Clin Obstet Gynecol. 2010 Mar;53(1):147-56
pubmed: 20142652
BMC Pregnancy Childbirth. 2016 Jan 28;16:23
pubmed: 26821645
Glob Health Action. 2014 Feb 13;7:23611
pubmed: 24560265
Int J Womens Health. 2013 Nov 13;5:737-52
pubmed: 24259988
Cochrane Database Syst Rev. 2020 Jul 1;7:CD013663
pubmed: 32609374
Cochrane Database Syst Rev. 2019 Jun 12;6:CD012392
pubmed: 31194903
J Adv Nurs. 2007 Jan;57(2):127-40
pubmed: 17214749
Lancet Glob Health. 2014 Jun;2(6):e323-33
pubmed: 25103301
BJOG. 2009 May;116(6):748-57
pubmed: 19432563
Obstet Gynecol. 2003 Apr;101(4):767-72
pubmed: 12681884
BMC Med Res Methodol. 2008 Jul 10;8:45
pubmed: 18616818
BJOG. 2013 Jan;120(1):5-14
pubmed: 22882240
Implement Sci. 2018 Jan 25;13(Suppl 1):2
pubmed: 29384079
BMJ Open. 2016 Jan 08;6(1):e010083
pubmed: 26747039
Int J Gynaecol Obstet. 2016 Jan;132(1):89-93
pubmed: 26475077
Int J Gynaecol Obstet. 2016 Nov;135(2):210-213
pubmed: 27530220
Am Fam Physician. 2017 Apr 1;95(7):442-449
pubmed: 28409600
PLoS One. 2018 May 17;13(5):e0197791
pubmed: 29772012
Int J Gynaecol Obstet. 2016 Jul;134(1):83-6
pubmed: 27085981
Obstet Gynecol. 2005 Dec;106(6):1228-34
pubmed: 16319245
Bull World Health Organ. 2007 Apr;85(4):322-3
pubmed: 17546315