Pregnancy and Childbirth
Conditions
Interventions
Sponsors
Eligibility
Inclusion criteria
Inclusion criteria: 1. 18 years or older 2. Delivery at 34 weeks or greater 3. Vaginal or cesarean delivery 4. Cumulative blood loss>1000ml within 24 after delivery 5. Uterine atony 6. Receipt of first-line uterotonics 7. Cervix at least 3 cm dilated at cesarean section
Exclusion criteria
Exclusion criteria: 1. Patient unwilling or unable to provide informed consent 2. Retained placenta or other known cause of postpartum hemorrhage 3. Placenta accreta spectrum 4. Coagulopathy 5. ruptured uterus 6. Surgical management immediately needed for life-threatening bleeding 7. Known contraindication for Jada System: on-going intrauterine pregnancy, untreated uterine rupture, unresolved uterine inversion, current cervical cancer, unknown uterine anomaly, current purulent infection.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Maternal survival without surgical intervention. | — |
Secondary
| Measure | Time frame |
|---|---|
| Time from randomization to control of bleeding ;Postpartum hemoglobin ;Change in hemoglobin from labor admission to postpartum day 1 ;Maternal transfusion of blood or blood products postpartum ;Number of units of blood products transfused ;Estimated blood loss post-randomization;Surgical procedures performed, including uterine vascular ligation, uterine compression sutures and hysterectomy. ;Maternal death postpartum ;Additional uterotonic used after randomization; Patient satisfaction score on a scale of 0 (least satisfied) to 10 (most satisfied);Composite adverse events potentially related to the Jada System, including genital tract injury, uterine perforation or rupture and endometritis.;Quality-adjusted Life-year based on the literature and Quality of Life Questionnaire (EQ-5D-5L);Incremental cost per quality-adjusted life-year | — |
Countries
Ghana
Contacts
Professor and Chair Women and Infants Hospital of Rhode Island