Five years follow-up of the Ready for Child trial

Abstract

In Australia, postpartum haemorrhage (PPH) occurs in 6.8–9.2% of all births, with variation between states. Australian and overseas data suggest the rates of PPH and associated morbidity are increasing, and that further research and improved management of the third stage of labour, including estimation of blood loss, are required. Australian clinicians tend to estimate third stage blood loss visually, which under estimates blood loss which can lead to an under-diagnosis of PPH and poor identification of women at risk of complications from anaemia. Anaemia associated with third stage blood loss significantly contributes to serious postnatal health complications and maternal mortality. A calibrated blood collection drape has been found to be more accurate for measuring third stage blood loss when compared to the visual method and this has led to World Health Organisation endorsement. The acceptability of the blood collection drape however has not been tested, nor has the accuracy of Australian midwives visual estimations of blood loss when compared to the drape measurement. We are testing the accuracy and acceptability of a calibrated blood collection drape in the Australian setting. Data will be collected in the birth suite setting using blood loss estimates from 75 vaginal births. During phase one of the study (50 births), the drape will be placed under the woman by the midwife researcher and blinded to the midwife. The drape measurement will be recorded bythe researcher. The blood in the drape will then be estimated by the midwife using standard methods; either visual or weighing after the bloodhas been removed from thedrape.Midwives’ estimations will be compared to the drape measurements via statistical analysis, measuring interclass correlation and Kappa statistics. During phase two of the study (25 births) midwives will be asked to use the drape and complete a survey focussing on acceptability. Study results will be presented at the conference.