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

BMJ. 2010 Feb 1;340:c293. doi: 10.1136/bmj.c293.


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 types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Specimen Collection / instrumentation*
  • Cluster Analysis
  • Delivery, Obstetric*
  • Female
  • Humans
  • Postpartum Hemorrhage / prevention & control*
  • Pregnancy
  • Prognosis

Associated data

  • ISRCTN/ISRCTN66197422