Abstract
Post-partum haemorrhage is among the main causes of (preventable) mortality for women in low-resource settings (LRSs), where, in 2017, the mortality ratio was 462 out of every 100 000 live births, over 10 times higher than for high-resource settings. There are different treatments available for post-partum haemorrhage. The intrauterine balloon tamponade is a medical device that proved to be a simple and cost-effective approach. Currently, there are several balloon tamponades available, with different design and working principles. However, all these devices were designed for high-resource settings, presenting several aspects that could be inappropriate for many lower-income countries. This paper presents the results of a preclinical study aiming at informing the design, prototyping and validation of a 3D-printed intrauterine balloon tamponade concept, contributing towards the United Nation’s Sustainable Development Goal 3: Good health and Well-being. Frugal engineering concepts and contextualised design techniques were applied throughout, to define the design requirements and specifications. The performance of the final prototype was validated against the requirements of the UK National Health System (NHS) technical guidelines and relevant literature, measuring the water leak and pressure drop over time, both open air and in a approximate uterus model. The resulting prototype is made up of six components, some of which are easy to retrieve, namely a water bottle, a silicone tube and an ordinary condom, while others can be manufactured locally using 3D printers, namely a modified bottle cap, a flow stopper and a valve for holding the condom in place. Validation testing bore promising results with no water or pressure leak open air, and minimal leaks in the approximate uterus model. This demonstrates that the 3D printed condom-based intrauterine balloon tamponade is performing well against the requirements and, when compared to the state of the art, it could be a more appropriate and more resilient solution to low-resource settings, as it bypasses the challenges in the supply of consumables and presents a greener option based on circular economy.
Funder
Engineering and Physical Sciences Research Council
H2020 Marie Skłodowska-Curie Actions
Publisher
Public Library of Science (PLoS)
Reference50 articles.
1. Second generation of intrauterine balloon tamponade: new perspective;Younes Bakri;BMJ innovations,2020
2. World Health Organization, “Maternal mortality,” https://www.who.int/news-room/fact-sheets/detail/maternal-mortality, 2021.
3. Organization, World Health, “Trends in maternal mortality 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division,” ISSN 9241516488, 2019.
4. Novel intrauterine balloon tamponade systems for postpartum hemorrhage;Eiji Kondoh;Acta Obstetricia et Gynecologica Scandinavica,2019
5. Condom tamponade in the management of primary postpartum haemorrhage: a report of three cases in Ghana;Ernest T Maya;African Journal of Reproductive Health,2015