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21-02-2010 | Gynaecology | Article

Collector bag after delivery does not impact severe postpartum hemorrhage rates

Abstract

Journal abstract

MedWire News: Researchers have found that the incidence of severe postpartum hemorrhage is not reduced by routine use of a collector bag to objectively measure postpartum blood loss after vaginal delivery.

Various maternity units across Europe routinely use a collector bag for measuring blood loss after vaginal delivery, as visual underestimation of blood loss may result in delaying diagnosis and initial care of postpartum hemorrhage. However, the usefulness of this practice has not been confirmed by studies.

To investigate, Wei–Hong Zhang (Université Libre de Bruxelles, Belgium) and colleagues randomly assigned 78 maternity units across 13 European countries involving 25,381 women with vaginal delivery to systematically use a collector bag (intervention group), or to continue visual assessment of postpartum blood loss (control group).

The primary outcome was the incidence of severe postpartum hemorrhage in vaginal deliveries, defined as a composite of one or more of blood transfusion, intravenous plasma expansion, arterial embolization, surgical procedure, admission to an intensive care unit, treatment with recombinant factor VII, and death.

Severe postpartum hemorrhage occurred in 1.71 percent of 11,037 vaginal deliveries in the intervention group, compared with 2.06 percent of 14,344 deliveries in the control group—a nonsignificant difference. This difference remained nonsignificant after individual or cluster level analysis.

Based on the study findings, the researchers suggest that that maternity units in high-income countries “reconsider their practice and possibly reallocate the resources to other aspects of care.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Ingrid Grasmo