Collector Bag Research Articles

Evaluation of measured postpartum blood loss after vaginal delivery using a collector bag in relation to postpartum hemorrhage management strategies: a prospective observational study.

To evaluate the incidence of postpartum hemorrhage (PPH) and severe PPH via routine use of a pelvic drape to objectively measure blood loss after vaginal delivery in connection with PPH management. This prospective observational study was undertaken at the obstetrical department of the Charité University Hospital from December 2011 to May 2013 and evaluated an unselected cohort of planned vaginal deliveries (n=1019 live singletons at term). A calibrated collecting drape was used to meassure blood loss in the third stage of labor. PPH and severe PPH were defined as blood loss ≥500 mL and ≥1000 mL, respectively. Maternal hemoglobin content was evaluated at admission to delivery and at the first day after childbirth. During the study period, 809 vaginal deliveries were analysed. Direct measurement revealed a median blood loss of 250 mL. The incidences of PPH and severe PPH were 15% and 3%, respectively. Mean maternal hemoglobin content at admission was 11.9±1.1 g/dL, with a mean decrease of 1.0±1.1 g/dL. Blood loss measured after vaginal delivery correlated significantly with maternal hemoglobin decrease. This study suggests that PPH incidence may be higher than indicated by population-based data. Underbuttocks drapes are simple, objective bedside tools to diagnose PPH. Blood loss should be quantified systematically if PPH is suspected.

Study protocol. TRAAP - TRAnexamic Acid for Preventing postpartum hemorrhage after vaginal delivery: a multicenter randomized, double-blind, placebo-controlled trial.

BackgroundPostpartum hemorrhage (PPH) is a major cause of maternal mortality, accounting for one quarter of all maternal deaths worldwide. Estimates of its incidence in the literature vary widely, from 3 % to 15 % of deliveries. Uterotonics after birth are the only intervention that has been shown to be effective in preventing PPH. Tranexamic acid (TXA), an antifibrinolytic agent, has been investigated as a potentially useful complement to uterotonics for prevention because it has been proved to reduce blood loss in elective surgery, bleeding in trauma patients, and menstrual blood loss. Randomized controlled trials for PPH prevention after cesarean (n = 10) and vaginal (n = 2) deliveries show that women who received TXA had significantly less postpartum blood loss without any increase in their rate of severe adverse effects. However, the quality of these trials was poor and they were not designed to test the effect of TXA on the reduction of PPH incidence. Large, adequately powered, multicenter randomized controlled trials are required before the widespread use of TXA to prevent PPH can be recommended.Methods and designA multicenter, double-blind, randomized controlled trial will be performed. It will involve 4000 women in labor for a planned vaginal singleton delivery, at a term ≥ 35 weeks. Treatment (either TXA 1 g or placebo) will be administered intravenously just after birth. Prophylactic oxytocin will be administered to all women. The primary outcome will be the incidence of PPH, defined by blood loss ≥500 mL, measured with a graduated collector bag. This study will have 80 % power to show a 30 % reduction in the incidence of PPH, from 10.0 % to 7.0 %.DiscussionIn addition to prophylactic uterotonic administration, a complementary component of the management of third stage of labor acting on the coagulation process may be useful in preventing PPH. TXA is a promising candidate drug, inexpensive, easy to administer, and simple to add to the routine management of deliveries in hospitals. This large, adequately powered, multicenter, randomized placebo-controlled trial seeks to determine if the risk-benefit ratio favors the routine use of TXA after delivery to prevent PPH.Trial registrationClinicalTrials.gov NCT02302456 (November 17, 2014)

Analyse descriptive du volume des pertes sanguines au cours de l’accouchement par voie basse et par césarienne

To describe the distribution of the volume of blood loss during vaginal and cesarean deliveries among women who delivered after 24 weeks of gestation. A descriptive study of the distribution of blood loss by delivery route and for all patients after 24 weeks of gestation over a period of two years in a type III maternity. Patient and delivery characteristics were collected and blood loss was measured prospectively based on weighing pads and the use of a collector bag for vaginal deliveries, a suction cannula for cesareans sections. The following parameters were calculated: the mean (±SD), the median, interquartile range (IQR), the 5th and 95th percentile. Seven thousand nine hundreds and eight patients were included. After vaginal delivery (n=6134), the mean volume of bleeding was equal to 180.1 mL (± 224.7 mL), the median to 100mL (IQR [100-200]), the 95th percentile to 500 mL [CI 95% 500-550]. For cesarean sections (n=1774), the mean volume of bleeding was equal to 557.9mL (± 496.2 mL), the median volume of blood loss to 400 mL (IQR [300-700]), the 95th percentile to 1300 mL [CI 95% 1200-1500]. The distribution of blood loss after cesarean was significantly higher than the distribution of blood loss after vaginal delivery.

Development of a New Mosquito Retention System for the BG-Malaria Trap To Reduce The Damage To Mosquitoes.

The BG-Malaria trap was recently modified from the BioGents BG-Sentinel trap to collect Anopheles species, including Anopheles darlingi. However, the captured mosquitoes often lose their hind legs in the collector bag, making them difficult to identify. To develop a new collector system that is capable of maintaining the integrity of the mosquitoes collected in the BG-Malaria trap, we conducted a study in the municipalities of Belém (Pará State [PA]) and Porto Velho (Rondônia State [RO]), Brazil, using carbon dioxide-baited BG-Malaria traps with 4 different mosquito collector systems: standard, no bag, rigid short, and rigid long. Results indicated significant differences among the numbers of mosquitoes captured in the 4 different collectors (P < 0.05). Additionally, significantly fewer insects (P < 0.05) were damaged using the rigid short and rigid long collectors than by using the standard and no-bag collectors. We observed that the longer the insects remained in the collector, the higher the number of damaged insects; this effect was the greatest in the standard collector. The results of this study indicate that rigid long collectors were the best suited for use in the BG-Malaria trap.

Viral contamination during sequential phacoemulsification surgeries in an experimental model

To determine the incidence of Piry virus contamination among surgical instruments used with disposable accessories for phacoemulsification during sequential surgeries. An experimental model was created with 4 pigs' eyes that were contaminated with Piry virus and 4 pigs' eyes that were not contaminated. Phacoemulsification was performed on the eyes, alternating between the contaminated and non-contaminated eyes. From one surgery to another, the operating fields, gloves, scalpel, tweezers, needles, syringes, tips and bag collector from the phacoemulsification machine were exchanged; only the hand piece and the irrigation and aspiration systems were maintained. In the collector bag, three samples from the contaminated eyes (3/4) were positive, and two samples from the non-contaminated (2/4) eyes were also positive; at the tip, one sample from the contaminated eyes (1/4) and two samples of the non-contaminated eyes (2/4) yielded positive results. In the irrigation system, one sample from a non-contaminated eye (1/4) was positive, and in the aspiration system, two samples from contaminated eyes (2/4) and two samples from non-contaminated eyes (2/4) were positive. In the gloves, the samples were positive in two samples from the non-contaminated eyes (2/4) and in two samples from the contaminated eyes (2/4). In the scalpel samples, three contaminated eyes (3/4) and none of the non-contaminated eyes (0/4) were positive; finally, two samples from the anterior chambers of the non-contaminated eyes gathered after surgery were positive. In two non-contaminated eyes, the presence of genetic material was detected after phacoemulsification surgery, demonstrating that the transmission of the genetic material of the Piry virus occurred at some point during the surgery on these non-contaminated eyes when the hand piece and irrigation and aspiration systems were reused between surgeries.

Effect of a Collector Bag for Measurement of Postpartum Blood Loss After Vaginal Delivery: Cluster Randomised Trial in 13 European Countries

Delay in the diagnosis and initial treatment of postpartum hemorrhage may occur as result of visual underestimation of blood loss. A number of studies have reported that visual estimates of postpartum blood loss are often inaccurate. To address this problem, the use of a collector bag has been proposed to provide an objective and more accurate measurement of blood loss than visual assessment. If effective, when excessive blood loss is observed, a more rapid response by a caregiver would be triggered. Currently, the bag is used routinely in many maternity wards in European countries despite lack of evidence for its efficacy. This cluster randomized controlled trial investigated the effectiveness of a transparent plastic collector bag in reducing the incidence of severe postpartum hemorrhage after vaginal delivery by providing an accurate measurement of postpartum blood loss. The trial was conducted at 78 maternity units in 13 European countries between 2006 and 2007. The participants—25,381 women who had a vaginal delivery—were randomized to systematic use of a collector bag (intervention group, n = 11,037) or to continued visual assessment of postpartum blood loss (control group, n = 14,344). The primary study outcome was the incidence of severe postpartum hemorrhage defined as a composite of all women who experienced one or more of the following: blood transfusion, intravenous plasma expansion, surgical procedure or arterial embolization, treatment with recombinant factor VII, or death. There was no statistical difference between the groups in the incidence of severe postpartum hemorrhage (intervention group: 1.71%, 189/11,037 vs. control group: 2.06%, 295/14, 344) using either individual level analysis or cluster level analysis. In individual level analysis (with data adjusted for maternal age, prophylactic uterotonics used in the third stage, mode of delivery, and birth weight), the adjusted odds ratio was 0.82, with a 95% confidence interval of 0.26 to 2.53, P = 0.7. In cluster level analysis, following adjustment for the baseline rate of severe postpartum hemorrhage, the adjusted weighted mean difference was 0.16%, with a 95% confidence interval of −0.69% to 1.02%, P = 0.7. These findings indicate that the systematic use of a collector bag after vaginal delivery does not reduce the rate of severe postpartum hemorrhage compared to visual estimation.

전력선 통신을 이용한 원격 집진기 bag 제어 시스템 개발

통신과 제어 기술의 발전과 인터넷 기능 강화로 이들을 이용해 전통 제조업에서 위험과 생산 비용을 줄이면서 제품의 성능을 향상시키기 위한 동기 인식이 확산되고 있다. 이에 본 논문에서는 첨단 IT 기술을 전통산업인 집진기에 융합한 지능형 원격 집진기 bag 제어 시스템을 이벤트 기반으로 개발하였다. 먼저 집진기의 센서인 차압 측정기의 아날로그 출력 데이터를 디지털로 변환시키는 A/D 변환기를 마이크로 프로세서를 사용하여 제작하였다. 또 이들을 RS-232 통신 방법으로 전력선 통신 모뎀과 연결하는 기술을 개발하였다. 다음은 전력선 통신을 이용하여 집진기 bag 상태 정보를 효율적으로 전송할 수 있도록 n-바이트 메시지 형식을 정의하였다. 그리고 집진기와 집진기 bag을 논리적으로 모델링하기 위해 자료형을 정의하였고, 이를 이용해 집진기와 집진기 bag을 XML과 객체지향 모델링 기법을 이용해 모델링하였다. 뿐만 아니라 집진기 bag의 교체시기를 정확하게 파악하여 집진기 bag의 교체시기를 관리자에게 실시간으로 다양한 시각적인 사용자 인터페이스를 이용해 제시하도록 개발하였다. Advances in communications and control technology, the strengthening of the Internet, and the growing recognition of the urgency to reduce the risk and production cost are motivating the development of improvements in the traditional manufacturing industry. In this paper, we developed a remote dust collector bag control system which is a combination of advanced IT and traditional dust collector based on the event. At first, we made the A/D(Analog/Digital) converter using a micro processor because the differential pressure transmission, which is a sensor of the dust collector, produces analog volt data. A/D converter can provide RS-232 communication to connect with Power Line Communication(PLC) modem. And, n-bytes message format was defined for the efficient dust collector bag information transmission from a dust collector to a user. Also, we designed the data types to model the dust collector and the dust collector bag, and they were logically modeled using XML and object-oriented modeling method. In addition to that, we implemented the system for showing the dust collector bag exchange time exactly to users at real-time using various visual user interfaces.

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

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...

Large-scale raceway nursery for improved scallop (Pecten maximus) spat production

Variable survival of small hatchery-produced Pecten maximus after transfer to sea has been considered a constraint to scallop spat production in Norway. A land-based raceway nursery was introduced as an intermediate step to bridge hatchery post-larval growth and growout in the sea to increase yield and stabilise spat production. The nursery was of a flow-through type with 10 parallel raceways (10m×0.6m×1.0m). Seawater (8–19°C) was filtered through 100μm mesh and pumped into the nursery at a rate of 6m3min−1 (2cms−1). Efficiency of the nursery was evaluated based on different growth trials comparing initial spat size, settlement technology and nursery type. Scallops settled either on downwelling screens or collector bags in the hatchery. Spat settled on screens were placed on trays before transfer to nursery, while collector bags were placed directly into raceways. The nursery facilitated growth of scallop spat from 1.5mm until saleable seed >15mm shell-height. Growth rates were 1.4–2.3% day−1 for spat of initial size 3, 5 and 7mm, and 4.2–5.2% day−1 for the fastest growing spat of mean initial size <2mm. The filter removed fouling organisms and predators successfully, and resulted in stable survival on land (85%), while survival varied from 36 to 84% in the sea. Yield of spat >5mm per collector bag varied from 46 to 2780, and was not affected by settlement conditions (colour of bag, water circulation and light conditions). Yield of competent larvae from trays averaged 18.9% on land and 14.2% in the sea and was superior to yield from collector bags (2.8%). The downwelling screen-tray method resulted in higher output per unit raceway than did the settlement and growth on collector bags and was thus regarded the most economical method. The land-based nursery had about 20% higher operational costs than the sea-based, but higher survival counterbalanced the extra costs. Using intermediate land-based nursery was proven advantageous to achieve a more cost-effective and stable production of 15–20mm P. maximus spat available to scallop growers in Norway.

Alternative means of nursery culture for commercial scallop ( Pecten fumatus Reeve) spat

Difficulties in controlling settlement densities of hatchery-produced Pecten fumatus larvae on mesh-filled collector bags prompted an evaluation of two alternative nursery-rearing protocols. In both cases, larvae were initially settled and on-grown on mesh downweller screens in the hatchery. In the first protocol, spat were retained on conventional downweller screens until it is large enough to be transferred to a field nursery system comprising tiered stacks of mesh screens located in upwelling systems. Mean growth rates were greatest for spat held on the first (most upstream) of eight screens within each stack and exhibited a progressive decline in successive downstream screens at all densities tested. Daily rotation of screen position within stacks overcame differential spat growth and significantly increased overall mean biomass gains. Stocking density per unit surface area of screen is critical in determining growth rate of P. fumatus spat in field upwellers. Irrespective of other growth-limiting factors such as food, the upper limit of stocking rate at which maximum growth rate is maintained is approximately 70% screen coverage. Although only marginal reduction in growth occurs at stocking rates of up to 100%, screen stocking rates above 70% coverage are not recommended because of the problem of death and damage that occurs through inadvertent clamping at higher densities. Maximum growth rates recorded for P. fumatus spat held in a single tier upweller screen coincided with high flow (l min −1) to biomass (kg) ratios of 20 to 30:1. Reuse of seawater via tiered upweller stacks enabled in the case of an eight-tiered stack up to a doubling of yield per unit of seawater flow. Optimised production efficiency would appear to coincide with use of about six to eight tiers per stack and daily alternation of screens from the top to bottom locations within the stacks. In the alternative nursery-rearing protocol, P. fumatus were settled on mesh screens using inexpensive nylon curtain material and retained in the hatchery for periods of 1–5 weeks post-settlement. The mesh from each screen was removed and was cut into sections with the desired number of spat attached. Each section was placed in a spat collector bag stuffed with conventional coarse plastic netting and was then deployed to the field. Subsequent survival of scallops after 30 days was found to depend on spat size at the time of deployment and upon handling methods used during deployment. The percentage of 500–750 μm spat (2–3 weeks post-settlement) recovered at a size of >5.0 mm, suitable for transfer to grow-out facilities, was 25–30% and comparable with that achieved in tiered upweller nurseries. However, screen to collector bag transfer requires less capital outlay and is less labour-intensive than tiered upweller systems.

Halotolerance of the oyster predator, Imogine mcgrathi, a stylochid flatworm from Port Stephens, New South Wales, Australia

The stylochid flatworm, Imogine mcgrathi was confirmed as a predator of the pteriid oyster Pinctada imbricata. Occurring at an average of 3.2 per oyster spat collector bag, the flatworms were found to consume oysters at a rate of 0.035–0.057 d−1 in laboratory trials. Predation was affected by flatworm size with larger worms capable of consuming larger oysters and of consuming greater dry weights of oyster flesh. Irrespective of flatworm size, predation was generally confined to oysters less than 40 mm in shell height. Although all predation occurred at night, shading flatworms during the day did not significantly increase the rate of predation, but there were significant increases in the dry weight of oyster meat consumed. As a means of controlling flatworm infestations, salt, brine baths (250 g kg−1) and freshwater baths were effective in killing I. mcgrathi. The ease of use of hyper- or hyposaline baths then encouraged assessments of I. mcgrathi halotolerance. The flatworms were exposed to solutions ranging in salinity from 0 to 250 g kg−1for periods of from 5 min to 3 h. Despite showing both behavioural and physiological signs of stress, I. mcgrathi survived the maximum exposure time of 3 h at salinities in the range 7.5–60 g kg−1, inclusive. Beyond this range, the duration of exposure tolerated by flatworms decreased until 0 and 250 g kg−1, at which the flatworms no longer survived the minimum tested exposure of 5 min. Thus, despite the significant impact of other stylochids on commercial bivalves, at their current prevalence, I. mcgrathi can be controlled by exposing them to hyper- and hyposaline baths for the culture of P. imbricata in Port Stephens, NSW, Australia.