Outcomes and Perceptions of the Implementation of the JADA Device in a Stage II Postpartum Hemorrhage Management Protocol in Referral Hospitals of the Colombian Pacific Region

NCT06843265 | Not Yet Recruiting

• 1 other identifier: 2024.271
• Study Type: interventional
• Target: 24
• Locations: 0 countries
• Sites: N/A

Brief Summary

This study focuses on postpartum hemorrhage (PPH), a condition that stands out as the leading cause of global maternal mortality. Annually, about 14 million women experience PPH, resulting in approximately 70,000 deaths. This condition presents a higher risk in low- and middle-income countries (LMICs), particularly where access to quality care is limited. Recognizing the urgency of addressing this public health problem, the Colombian Ministry of Health and Social Protection has implemented the Maternal Mortality Reduction Acceleration Plan (PARE) to improve maternal mortality indicators and meet the Sustainable Development Goals (SDGs). The project will evaluate the results and perception of a new device in the management of stage II PPH in referral hospitals in the department of Valle del Cauca, integrated in the Hospital Padrino strategy. This initiative seeks not only to improve the understanding and treatment of PPH, but also to strengthen institutional capacities through education, creation of telecare networks and care services adapted to local needs.

Conditions

Post Partum Haemorrhage

Keywords

maternal mortality; Shock Index; care bundle

Outcome Measures

Primary Outcomes (1)

• Bleeding control

  Postpartum hemorrhage defined as quantified bleeding of more than 500 ml for vaginal deliveries and more than 1000 ml for cesarean deliveries, occurring within the first 24 h after delivery and which may be associated with signs of hemodynamic instability, i.e. the ratio between heart rate and systolic blood pressure (shock index). Following this concept of the shock index and the amount of bleeding, the stages of postpartum hemorrhage are divided, which, according to the result of the shock index, the therapy is directed: Stage 1: Bleeding 500-1000 cc, Shock index of \<0.9, bleeding time \<10 minutes. Stage 2: Bleeding 1000-1500 cc, shock index 0.9-1.4 bleeding time 10-20 minutes. Stage 3: Bleeding \<1500 cc, shock index \>1.5, bleeding time greater than 20 minutes. Stage 4: Cardiovascular collapse with profound hypovolemic shock and coagulopathy. These stages will be measured through a bag which will fulfill the function of measuring to indicate the stage and amount of bleeding

  up to 42 days postpartum

Study Arms (1)

Group 1

EXPERIMENTAL

Pregnant women with stage II postpartum hemorrhage, after vaginal delivery, who have had the JADA device implemented and meet INVIMA's definition of use of the instrument: the JADA system is intended to provide control and treatment of abnormal postpartum uterine bleeding or postpartum hemorrhage when conservative management is warranted, attended in hospitals in the context of the Godfather Hospital Strategy in the department of Valle del Cauca.

Device: Vacuum- Induce Hemorrhage Control

Interventions

Vacuum- Induce Hemorrhage Control DEVICE

The JADA System is designed for single use only and is composed of medical grade silicone. Its components include an intrauterine loop with protected vacuum pores, a cervical seal with a sealing valve for infusing saline and a vacuum connector port for applying suction. The intrauterine loop is located at the distal end of a tube and contains 20 protected vacuum pores oriented inward along the loop. This shielded design facilitates intracavitary suction by shielding maternal tissue from the vacuum source and prevents clogging of the vacuum pores with tissue or clot.

Group 1

Eligibility Criteria

• Age: 18 Years+
• Gender Eligibility Details: women by birth
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Pregnant women who are admitted to the obstetrics service scheduled for vaginal delivery in any of the participating hospitals: Fundación Valle del Lili, Hospital Universitario del Valle and Hospital Luis Ablanque de la Plata.
• Patient admitted during the shift of one of the gynecologists trained in the use of the JADA device in the context of the research project.
• Criteria for the use of JADA device:
• Pregnant women over or equal to 18 years of age.
• Gestational age of pregnancy greater than 32 weeks of gestation.
• Pregnant with vaginal delivery.
• Pregnant with postpartum hemorrhage due to uterine atony that does not respond to treatment with uterotonics and uterine massage.
• Postpartum hemorrhage uterine stage/stage II.
• Vaginal delivery attended in a health institution in the context of the Hospital Padrino strategy (Fundación Valle del Lili or Hospital Universitario del Valle or Hospital Luis Ablanque de la Plata).

You may not qualify if:

• Patients who, according to the attending physician's criteria, are not candidates for vaginal delivery.
• Abnormality of the normal uterine anatomy.
• Placental abnormalities.
• Maternal anemia with hemoglobin less than 7 mg/dl prior to delivery.
• Those who do not sign informed consent.

Sponsors & Collaborators

• Fundacion Clinica Valle del Lili: lead
• Hospital Universitario del Valle Evaristo Garcia: collaborator

MeSH Terms

Conditions

Postpartum Hemorrhage; Maternal Death

Condition Hierarchy (Ancestors)

Obstetric Labor Complications; Pregnancy Complications; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Puerperal Disorders; Uterine Hemorrhage; Hemorrhage; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Parental Death; Death

Central Study Contacts

Maria F Escobar, Gynecologist and Obstetrician

CONTACT

+57 315 433 1584; maria.escobar.vi@fvl.org.co

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Global health equity unit director

Study Record Dates

• First Submitted: February 14, 2025
• First Posted: February 24, 2025
• Study Start: June 1, 2025
• Primary Completion: December 31, 2025
• Study Completion: December 31, 2025
• Last Updated: February 24, 2025

Record last verified: 2025-02