This post is the 2nd in a series on the LifeWrap.  This neoprene suit also called the NASG helps stabilize a woman experiencing postpartum hemorrhage is currently in clinical trials.  Much of the current litrature focuses on the clinical trials, but we were curious to find out a little bit more about the garment/device and who is already using the LifeWrap.  The Nigerian Ministry of Health was so convinced of its effectiveness that the LifeWrap is being scaled up in Safe Motherhood programs there with the help of Pathfinder International.  And PATH is helping to find a potential lower-cost manufacturer of the device which is still $175 per suit.   Suellen Miller is leading the effort to rigorously evaluate the LifeWrap and her answers to our questions are printed in full below.

Are there any countries that are already using the LifeWrap based on clinical trials thus far? Any individual projects/clinics outside of the clinical trials?

"The LifeWrap is used in Nigeria (which has one of the highest maternal mortality rates in the world). Our research in Northern and Southern states of Nigeria between 2004 – 2008 not only showed amazing benefits to hemorrhaging women, but also high level of acceptance from providers, and support from the government, so much so that the Nigerian government approved the continued, and scaled-up use of the NASG which was integrated into a Continuum of Care for PPH program by Pathfinder International. Today, many health care facilities in Nigeria continue to use the NASG to great effect. Pathfinder, with technical assistance from me (Suellen Miller), is also introducing the NASG into the CCPPH program in India, Peru, Bangladesh, and Tanzania."

If one of our readers wanted to buy the suit for use right now, what would be the barriers?

"Anyone can purchase a NASG from the sole distributor, Zoex, PO Box 435, Ashland, Oregon, 97520, Fax 541-482-8337, zoex@connpoint.net.

However, the NASG should be part of a health care system. While the NASG is a first-aid device, which, if applied by someone who has received training, can stabilize a woman in shock, that woman still needs definitive emergency obstetrical care. So she will need to be referred in the NASG to a hospital, or if she is in a hospital, she will need to receive IV fluids, possibly a blood transfusion, medication for uterine atony, and, perhaps, surgery. Once the NASG has been placed, which, again, can be done by anyone who has been trained, it can only be removed in a skilled facility, under skilled supervision, and with an IV in place. If the NASG is removed before the source of bleeding has been corrected, the woman may go into deep, severe shock.

So the barriers to wide-spread use include not only obtaining an NASG, but obtaining training, integrating the NASG into the health system, and integrating the NASG into shock and hemorrhage protocols."

 Where is the WHO in terms of the process of prequalifying the device or do they even have the setup to do that right now?

"The WHO demands the most rigorous research to be carried out before a device can be added to their ‘List of Essential Devices’ or to their Guidelines which is our aim. We are currently conducting a Randomized Cluster Trial (RCT) in Zambia and Zimbabwe, which will hopefully provide the evidence necessary to be included on this list. The study involves application of the NASG at the primary health care level, before transporting the woman to the tertiary center. The WHO stated in their latest guidelines on PPH treatment and management that they are withholding judgment on integrating shock garments into the guidelines pending the outcomes of the Zambia/Zimbabwe RCT.

I seem to recall that the suits are $175 if bought from Zoex directly. Is that right?

"I believe that $170 is the approximate cost for the NASG, then there are shipping costs, and, if bringing into a country outside the US there may be additional customs /import duties.

Please note that the LifeWrap group holds a benefit in honor of Mother's Day--and suggests that you buy a LifeWrap in honor of your own mother."