‘Chhattisgarh balloon’ to bring down maternal mortality

In a significant innovation, a team of doctors in Pt. Jawaharlal Nehru Medical College here has developed a device christened the Chhattisgarh Balloon, which promises to bring down maternal mortality drastically, particularly in third world countries, by effectively controlling postpartum uterine bleeding in just delivered mothers.

The Chhattisgarh Balloon, a result of year-long research by a team of four doctors led by professor of gynaecology and obstetrician Nalini Mishra at the JNMC, is tipped to usher in remarkable improvement in the prevailing gloomy maternal mortality scenario in developing countries where postpartum haemorrhage contributes to as high as 33 per cent of the total maternal mortality, by saving lives of new mothers.

“The newly developed device, which can be made in the labour room itself in just two minutes at a cost of barely `100, may prove to be a revolutionary innovation primarily for three reasons — it is cost effective, it is easily available even in primary health centres located in remote areas, and, importantly, technically and performance wise, it is nearly as perfect as branded uterine specific devices (USDs) such as Bakri Balloon available in the market,” Dr Mishra, who was accorded standing ovation at the Indian Medical Association conference here recently for the invention, told this newspaper.

According to Dr Mishra, the commercially available UDS with provision the of a drainage channel is considered ideal for managing postpartum haemorrhage, but its prohibitive prices have forced doctors in developing countries to find a substitute in condom balloon tamponade (CBT), prepared in the labour room.

CBT is made in the labour room by fastening a fresh condom with a catheter with the help of cotton thread.

This is then inserted in the uterus cavity and then inflated with administration of saline fluid. This helps reduce uterine bleeding.

But the conventional CBT has many drawbacks including non-provision of a drainage channel, thus denying the doctors the opportunity to assess ongoing uterine bleeding.

Secondly, the thread used to tie the catheter with condom sometimes snap causing leakage of fluid from balloon and in the process defeating the whole purpose.

“The Chhattisgarh Balloon has successfully overcome both these drawbacks,” Dr Mishra said.

Cases of postpartum haemorrhage, caused usually by failure of contraction of uterus in the mother after childbirth, often could not be managed particularly in PHCs or village hospitals which lack surgery facilities as well as specialist doctors, leading to maternal mortalities.

In response to a call by the World Health Organisation to identify the area as priority for research, Programme for Appropriate Technology in Health (PATH), a widely acclaimed international non-profit organisation, said in 2013 that the conventional CBT can be significantly improved to effectively manage uterine bleeding during childbirth.

“The Chhattisgarh Balloon is an improvisation of CBT with provision of a drainage lumen. It proved effective in almost 95 per cent postpartum haemorrhage cases during trial,” Dr Mishra said.

The components used in the device such as foley’s catheter, fresh condom, scissors, normal saline and two syringes of 10 ml and 20 ml capacity, are available in any labour room.

The International Federation of Gynaecologists and Obstetricians (FIGO) has endorsed the innovation.

FIGO has selected the invention to publish it in its International Journal of Gynaecology and Obstetrics, in the next issue.

Journal of Obstetrics and Gynaecology of India, a publication of Federation of Obstetrics and Gynaecology Society of India, carried an article on the innovation in its online edition dated December 22, 2015.

“A government-backed initiative to create awareness on the innovation across the country can save lives of many women particularly from the disadvantaged sections,” she said.

Other members of the team comprise assistant professor Sumi Agrawal, associate professor Chandrasekhar Srivastav and resident medical officer Kanchan Gulbani.