Simple technology saving mothers’ lives Tucked in the tea plantation-dominated rolling hills of Nyamira County, is Everlyn Nyasuguta who is a living testimony to the miracle that a condom tied to a tube has become in these part. Everlyn, a 32 year old teacher, would have joined the statistics of women whose lives waste away when postpartum hemorrhage (PPH) – the irregular bleeding that comes after birth – sets in. Statistics from the Kenya Health Information System (KHIS) show that the number of maternal deaths associated with PPH has been on the increase. In 2015, Kenya reported 11,770 maternal deaths, 2,246 more than the 9,524 recorded in 2014. 2016 could be even worse — by October 2016, 9,854 mothers have lost their lives due to PPH. Tragically, these mothers die while giving life - a fate that can be arrested by the use of the Uterine Balloon Tamponade known by its acronym, UBT.
When Everlyn Nyasuguta went into labor on November 8, 2015, it did not occur to her that bringing forth another life would end up in a near death experience. Watching over her active son, Ernest, Everlyn speaks about the ordeal that scarred her for life.
was well. Everyone thought that the crisis had been resolved but after Everlyne relieved herself and the balloon slipped out of her uterus she began bleeding again. It was decided that she should be rushed to the Nyamira County Hospital (NCH).
“That morning when I went into labor my husband took me to Nyamusi Sub-district Hospital (NSH). We got there at 6.00am and a clinician, who was clocking out of duty, assessed my condition and put me on saline drips. Based on my dilation he observed that I should deliver by 11am. He was shocked when, upon resuming duty for the night shift at 6pm, I had not yet delivered.” Everlyn says.
“I had bled for a long time that by the time we were reaching NCH, I was barely conscious and could not speak, but I did not stop praying. As soon as she got to NCH, they commenced blood transfusion. Things seemed to settle again, but two days later I began to bleed again. I was rushed to the theatre.
This had him worried. He later confided in me that when he had examined me in the morning he was not too comfortable. A thought had crossed his mind that I would have been better off at the better equipped Nyamira County Hospital. I had by this time been in labor for so long that I was growing pale and becoming weaker by the minute. His misgivings aside he assisted me and I gave birth to a baby boy. Usually this should mark the end of the drama, but it was just beginning.
“If it were not for the UBT, I would not be alive. It saved my life.”
UBT, a simple technology, has saved lives of mothers in Kenya faced with excessive bleeding after delivery. The most common causes of PPH are: distended bladder, uterine atony (occuring when the uterus fails to contract after the delivery of the baby), lacerations of the uterus, cervix or vagina, retained placenta or clots. The use of UBT in managing and treating PPH involves inserting the balloon device into the uterus and then incrementally filling it with liquid. As the balloon swells it slowly applies pressure to the uterus walls until the bleeding stops. UBT is a minimally invasive obstetric intervention that effectively controls severe bleeding that leads to death when all other options are unavailable or have been tried and failed.
The surgery revealed that Everlyne had suffered uterine rapture during delivery. The doctors noted that her uterus was damaged to the point that she had to undergo hysterectomy – her entire uterus was surgically removed. “I was placed under medication and discharged from hospital after two weeks. After that I attended clinic every month for five months until I was
A few hours after delivery, Everyln began bleeding profusely. “The bleeding was so heavy. I was afraid I was going to die. I thought of my children and how they would fare without me. I kept on praying that my situation would be contained. I had been given a drug they called misoprostol earlier - but the bleeding did not stop,” she said. Eveline’s situation deteriorated and the clinician on site opted to use the UBT. The bleeding stopped and she thought all
Everlyne Nyasuguta and the son Ernest during an interview with PATH at the NSC. Photo: PATH/Christine Ogutu
completely healed,” she said. She adds: “If it were not for the UBT I would not be alive” she says adding "It saved my life." Article by Christine Ogutu, PATH/ Communications