Shock Index for Predicting Adverse Obstetric Hemorrhage Outcome

This dataset includes clinical data for 958 women comprising
pre-intervention/control participants from four studies conducted by the
Safe Motherhood Program at the University of California, San Francisco
that evaluated the effectiveness of the non-pneumatic anti-shock garment
(NASG) to reduce adverse maternal outcomes for women with hypovolemic
shock secondary to severe obstetric hemorrhage: Egypt 2004 (n=158), Egypt
2006-2008 (n=430), Nigeria 2004-2007 (n=179) and Zambia and Zimbabwe
2007-2012 (n=191) and were not missing data on vital signs or death. Three
of these studies, based at the tertiary level, followed a
quasi-experimental design where a pre-intervention period was temporally
followed by an NASG intervention period, and one was a cluster-randomized
control trial (CRCT) of NASG application at the primary health clinic
(PHC) level, prior to transport to tertiary facility for definitive
treatment. The pre-intervention/control participants in all studies
received standardized evidence-based hemorrhage and shock management.
Women in all trials were eligible for study participation if they reached
a threshold estimated blood loss and one or more of the following: SBP
< 100 mm Hg and/or pulse > 100 BPM. In the tertiary facility
studies in Egypt and Nigeria, the threshold estimated blood loss was
>750ml, while in the Zambia and Zimbabwe PHC-enrolled study the
threshold EBL was >500 mL. The majority of facilities were
under-staffed, under-resourced, and characterized by long delays in
obtaining definitive care (surgery, blood transfusions). Initial study
protocols, including informed consent procedures, were approved by
institutional review boards at the University of California, San
Francisco, and for each study, respectively, by the following
institutions: University of Zambia, Lusaka Research Ethics Committee;
Medical Research Council of Zimbabwe; Department of Reproductive Health
and Research of the World Health Organization Ethics Review Committee;
National Reproductive Health Research Committee of the Nigerian Federal
Ministry of Health, El Galaa Maternity Teaching Hospital; Assiut
University Women’s Health Center; Alexandria University Teaching Hospital;
and Al Minya University Teaching Hospital. All women provided written or
thumbprint (if illiterate) informed consent for study participation; all
ethics committees provided a waiver of consent from women who were
unconscious or confused at time of admission until they recovered or
written consent was obtained from a relative as proxy.