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


METHODS
Cluster randomised trial.


METHODS
13 European countries.


METHODS
78 maternity units and 25 381 women who had a vaginal delivery.


METHODS
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).


METHODS
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 difference was not statistically significant either in individual level analysis (adjusted odds ratio 0.82, 95% confidence interval 0.26 to 2.53) or in cluster level analysis (difference in weighted mean rate adjusted for baseline rate 0.16%, 95% confidence interval -0.69% to 1.02%).


CONCLUSIONS
Compared with visual estimation of postpartum blood loss the use of a collector bag after vaginal delivery did not reduce the rate of severe postpartum haemorrhage.


BACKGROUND
Current Controlled Trials ISRCTN66197422.
Zhang
Wei-Hong
WH
Perinatal Epidemiology Research Unit, School of Public Health, Université Libre de Bruxelles, Route de Lennik 808, CP 597, B-1070 Bruxelles, Belgium. wzhang@ulb.ac.be
Deneux-Tharaux
Catherine
C
Brocklehurst
Peter
P
Juszczak
Edmund
E
Joslin
Matthew
M
Alexander
Sophie
S
D000328:Adult; D001800:Blood Specimen Collection / Q000295:instrumentation*; D016000:Cluster Analysis; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011247:Pregnancy; D011379:Prognosis