Trial reportBJOG : an international journal of obstetrics and gynaecology2010
Multifaceted intervention to decrease the rate of severe postpartum haemorrhage: the PITHAGORE6 cluster-randomised controlled trial.
Trial report in BJOG : an international journal of obstetrics and gynaecology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 105 citations in OpenAlex.
- Implementation strategies for WHO guidelines to prevent, detect, and treat postpartum hemorrhage.The Cochrane database of systematic reviews · 2025Pooled it
- Care technologies to prevent and control hemorrhage in the third stage of labor: a systematic review.Revista latino-americana de enfermagem · 2019Pooled it
- Treatment for primary postpartum haemorrhage.The Cochrane database of systematic reviews · 2014Pooled it
- Trial
- Study protocol. TRAAP - TRAnexamic Acid for Preventing postpartum hemorrhage after vaginal delivery: a multicenter randomized, double-blind, placebo-controlled trial.BMC pregnancy and childbirth · 2015Trial
- Effect of routine controlled cord traction as part of the active management of the third stage of labour on postpartum haemorrhage: multicentre randomised controlled trial (TRACOR).BMJ (Clinical research ed.) · 2013Trial
- Study protocol. TRAAPREVIA-TRAnexamic acid for preventing blood loss following a cesarean delivery in women with a placenta pREVIA or low-lying placenta: a multicenter randomized, double blind, placebo controlled trial.BMC pregnancy and childbirth · 2025Article
- Trans-arterial embolization for intractable primary postpartum hemorrhage caused by arterial aneurysms with arteriovenous fistulas in the lower vagina bilaterally: a case report.The Journal of international medical research · 2023Article
- How to Improve the Care of Women after Childbirth in the Rooming-in Unit: A Prospective Observational Study.International journal of environmental research and public health · 2022Observational
- Does the Quality of Postpartum Hemorrhage Local Protocols Improve the Identification and Management of Blood Loss after Vaginal Deliveries? A Multicenter Cohort Study.Healthcare (Basel, Switzerland) · 2022Article
- Carbetocin versus Oxytocin for the Prevention of Postpartum Hemorrhage in Cesarean Deliveries: A Retrospective Study of Two Consecutive Periods.AJP reports · 2020Article
- TRAAP2 - TRAnexamic Acid for Preventing postpartum hemorrhage after cesarean delivery: a multicenter randomized, doubleblind, placebo- controlled trial - a study protocol.BMC pregnancy and childbirth · 2020Article
- The Oxytocin Product Correlates with Total Oxytocin Received during Labor: A Research Methods Study.American journal of perinatology · 2018Article
- Risk Factors for Severe Postpartum Hemorrhage After Cesarean Delivery: Case-Control Studies.Anesthesia and analgesia · 2017Observational
- Use of a Visual Aid in addition to a Collector Bag to Evaluate Postpartum Blood loss: A Prospective Simulation Study.Scientific reports · 2017Article
- Implementation of effective practices in health facilities: a systematic review of cluster randomised trials.BMJ global health · 2017Article
- Article
- Influencing factors for high quality care on postpartum haemorrhage in the Netherlands: patient and professional perspectives.BMC pregnancy and childbirth · 2015Article
- Is accurate and reliable blood loss estimation the 'crucial step' in early detection of postpartum haemorrhage: an integrative review of the literature.BMC pregnancy and childbirth · 2015Review
- Duration of Expulsive Efforts and Risk of Postpartum Hemorrhage in Nulliparous Women: A Population-Based Study.PloS one · 2015Article
Corrections and comments
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Authors and funding
13 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveDecreasing the prevalence of severe postpartum haemorrhages (PPH) is a major obstetrical challenge. These are often considered to be associated with substandard initial care. Strategies to increase the appropriateness of early management of PPH must be assessed. We tested the hypothesis that a multifaceted intervention aimed at increasing the translation into practice of a protocol for early management of PPH, would reduce the incidence of severe PPH.
designCluster-randomised trial. POPULATION: 106 maternity units in six French regions.
methodsMaternity units were randomly assigned to receive the intervention, or to have the protocol passively disseminated. The intervention combined outreach visits to discuss the protocol in each local context, reminders, and peer reviews of severe incidents, and was implemented in each maternity hospital by a team pairing an obstetrician and a midwife.
main outcome measuresThe primary outcome was the incidence of severe PPH, defined as a composite of one or more of: transfusion, embolisation, surgical procedure, transfer to intensive care, peripartum haemoglobin decrease of 4 g/dl or more, death. The main secondary outcomes were PPH management practices.
resultsThe mean rate of severe PPH was 1.64% (SD 0.80) in the intervention units and 1.65% (SD 0.96) in control units; difference not significant. Some elements of PPH management were applied more frequently in intervention units-help from senior staff (P = 0.005), or tended to - second-line pharmacological treatment (P = 0.06), timely blood test (P = 0.09).
conclusionThis educational intervention did not affect the rate of severe PPH as compared with control units, although it improved some practices.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.