Postpartum Hemorrhage Clinical Trial
Official title:
A Comparison of the Excellent BRASSS-V Drape™ and an Indirect Blood Measurement Protocol for the Measurement of Blood Loss During Third Stage of Vaginal Delivery
Postpartum hemorrhage is one of the most common causes of maternal mortality and serious
maternal morbidity, especially in the developing world. In India, hemorrhage is a major
cause of maternal mortality: A study by the Register General in 1993 showed that 23 percent
of all maternal deaths in rural areas were caused by hemorrhage (Sibley, 2005).
The measurement of postpartum blood loss and identification of postpartum hemorrhage are
important measures in efforts to prevent and treat postpartum hemorrhage. In recent years,
researchers have employed several different methods to measure blood loss in hospital and
community-based birth settings. Although research has demonstrated that these laboratory
measures are more accurate then visual estimation techniques, no studies have explicitly
documented the systematic differences (if any) among different collection modalities.
Moreover, only a few of these studies have correlated measured blood loss with changes in
hemoglobin levels experienced between the antepartum and postpartum period. The aim of this
study is to compare variations in the measurement of blood loss obtained using two popular
measurement methods: the Excellent BRASSS-V Drape™ and a modified version of the blood
collection method developed by the World Health Organization (WHO).
Postpartum hemorrhage is one of the most common causes of maternal mortality and serious
maternal morbidity, especially in the developing world. In India, hemorrhage is a major
cause of maternal mortality: A study by the Register General in 1993 showed that 23 percent
of all maternal deaths in rural areas were caused by hemorrhage (Sibley, 2005).
The measurement of postpartum blood loss and identification of postpartum hemorrhage are
important measures in efforts to prevent and treat postpartum hemorrhage. However, visual
estimation of postpartum hemorrhage often leads to underestimation of blood loss and
subsequent delays in the seeking or provision of appropriate treatment. In recent years,
researchers have employed several different methods to measure blood loss in hospital and
community-based birth settings. Although research has demonstrated that these laboratory
measures are more accurate then visual estimation techniques, no studies have explicitly
documented the systematic differences (if any) among different collection modalities.
Moreover, only a few of these studies have correlated measured blood loss with changes in
hemoglobin levels experienced between the antepartum and postpartum period. The aim of this
study is to compare variations in the measurement of blood loss obtained using two popular
measurement methods: the Excellent BRASSS-V Drape™ and a modified version of the blood
collection method developed by the World Health Organization (WHO).
We propose a randomized prospective study to compare the measurement of blood loss during
the third stage of labor with two different methods: the modified WHO blood measurement
protocol and the Excellent BRASSS-V Drape™. Upon admission in the labor ward, study staff
will approach all delivering women about participation in the study and seek informed
consent. Blood loss will be measured for all consenting women with vaginal deliveries.
Women who agree to participate will be randomized to one of two blood collection techniques:
a modified version of the WHO blood measurement protocol or the Excellent BRASSS-V Drape™.
Blood loss will be measured from immediately after delivery and cord clamping for a period
of at least one hour or until active bleeding stops. The blood loss will then be quantified
by the study staff and recorded on the study form. Women will receive the facility's
standard care for the management of the third stage of labor and, if applicable, treatment
of PPH.
Measures of postpartum hemoglobin levels will be taken at admission for delivery and
twenty-four hours post-delivery for a randomly selected sub-set of study participants.
Besides the measurement of blood loss and the regular measurement of hemoglobin for a
sub-sample of participants, there will be no change to the hospital's standard procedures
for labor and delivery.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label
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