Theme

RESEARCH

Effect of a collector bag for measurement of postpartum blood loss after vaginal delivery: cluster randomised trial in 13 European countries

Wei-Hong Zhang, senior researcher,1 Catherine Deneux-Tharaux, senior researcher,2 Peter Brocklehurst, professor of perinatal epidemiology,3 Edmund Juszczak, senior medical statistician,3 Matthew Joslin, general practitioner,1 Sophie Alexander, professor of public health1 on behalf of the EUPHRATES Group

1 Perinatal Epidemiology Research Unit, School of Public Health, Université Libre de Bruxelles, Route de Lennik 808, CP 597, B1070 Bruxelles, Belgium 2 INSERM, UMR S953, UPMC, Epidemiological Research Unit on Perinatal Health and Women’s and Children’s Health, Paris, France 3 National Perinatal Epidemiology Unit, University of Oxford, Oxford Correspondence to: W-H Zhang wzhang@ulb.ac.be

Cite this as: BMJ 2010;340:c293 doi:10.1136/bmj.c293

ABSTRACT Objective To evaluate the effectiveness of the systematic use of a transparent plastic collector bag to measure postpartum blood loss after vaginal delivery in reducing the incidence of severe postpartum haemorrhage. Design Cluster randomised trial. Setting 13 European countries. Participants 78 maternity units and 25 381 women who had a vaginal delivery. Interventions Maternity units were randomly assigned to systematic use of a collector bag (intervention group) or to continue to visually assess postpartum blood loss after vaginal delivery (control group). Main outcome measures The primary outcome was the incidence of severe postpartum haemorrhage in vaginal deliveries, defined as a composite of one or more of blood transfusion, intravenous plasma expansion, arterial embolisation, surgical procedure, admission to an intensive care unit, treatment with recombinant factor VII, and death. Results Severe postpartum haemorrhage occurred in 189 of 11 037 of vaginal deliveries (1.71%) in the intervention group compared with 295 of 14 344 in the control group (2.06%). The...