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

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 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%). CONCLUSION: 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. TRIAL REGISTRATION: Current Controlled Trials ISRCTN66197422.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1136/bmj.c293

Authors

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Institution:
University of Oxford
Division:
MSD
Department:
Nuffield Department of Population Health
Sub department:
NPEU
Role:
Author


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Grant:
QLG4-CT-2001-01352


Publisher:
BMJ Publishing Group
Journal:
BMJ (Clinical research ed.) More from this journal
Volume:
340
Issue:
feb01 1
Pages:
c293
Publication date:
2010-01-01
DOI:
EISSN:
1756-1833
ISSN:
0959-8138


Language:
English
Keywords:
Pubs id:
pubs:309114
UUID:
uuid:094dd115-cf9c-4c2c-ac0d-0bee604313a9
Local pid:
pubs:309114
Source identifiers:
309114
Deposit date:
2012-12-19
ARK identifier:

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