Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide and accounts for 25% of delivery-associated deaths. Approximately 80% of PPH cases are a result of uterine atony. The woman’s uterus is unable to contract; thus, the blood vessels continue to bleed. In such cases, doctors usually go for a combination of medications and a uterine balloon tamponade. The tamponade is inserted into the uterus, and as the balloon expands it exerts pressure on the uterine walls and vessels. Thus, stopping the bleeding. However, it is an invasive procedure and can result in complications such as uterine perforation, cervical tears, and infection. Therefore, researchers have developed a new intrauterine device for treating postpartum hemorrhage.
The Jada System is a novel intrauterine vacuum-induced hemorrhage-control device that aims to control postpartum hemorrhage using suction. The device is made of soft silicone and consists of an intrauterine loop with 20 vacuum pores. The vacuum is held within the uterus with the help of an expandable cervical seal filled with sterile fluid. A connector at the end of the tube is then attached to a vacuum source.
The device creates a negative pressure within the uterus, causing it to shrink and collapse. As a result, the blood vessels contract, and the bleeding stops. In a way, the device mimics the body’s natural post-birth process of uterine contraction.
The Jada System was specifically designed to offer rapid treatment by applying low-level intrauterine vacuum to facilitate the physiologic forces of uterine contractions to constrict myometrial blood vessels and achieve hemostasis.
– Dr. Mary E. D’Alton, study author
Bleeding Controlled Within 3 Minutes
A team of researchers evaluated the effectiveness and safety of the vacuum device among 107 women with postpartum hemorrhage or abnormal postpartum uterine bleeding. The study was conducted across 12 centers in the United States. According to the results, the treatment helped control bleeding in 94% of the participants, within a median of 3 minutes after vacuum attachment.
The study reported 8 adverse events related to the treatment: 4 cases of endometritis, and one case each of presumed endometritis, bacterial vaginosis, vaginal candidiasis, and disruption of a vaginal laceration repair. However, all resolved without any serious clinical complications. Moreover, 35 patients required blood transfusions with 1-3 units of blood. A further 5 required 4 or more units.
Jada is a safe and effective option for women with postpartum bleeding that works quickly and has a short overall treatment time, which allows patients to resume postpartum activities. – Dr. Dena Goffman, study author
Unlike other available treatments, the vacuum device does not require anesthesia and can be placed immediately in emergency situations. Moreover, all first-time users found the system easy to use. Therefore, study authors conclude the method as safe and effective for rapid treatment of postpartum bleeding.
Reference:
D’Alton, Mary E., et al. “Intrauterine Vacuum-Induced Hemorrhage-Control Device for Rapid Treatment of Postpartum Hemorrhage.” Obstetrics & Gynecology, vol. 136, no. 5, 2020, pp. 882–891., doi:10.1097/aog.0000000000004138.
