ArticleSingapore medical journal2016
Postpartum blood loss: visual estimation versus objective quantification with a novel birthing drape.
Article in Singapore medical journal, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 4 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 4 syntheses or guidelines pooled it, 68 citations in OpenAlex.
- FIGO recommendations on objective measurement of blood loss after birth for early detection of postpartum hemorrhage.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Guideline
- Tests for diagnosis of postpartum haemorrhage at vaginal birth.The Cochrane database of systematic reviews · 2025Pooled it
- Pooled it
- Quantification of blood loss for the diagnosis of postpartum hemorrhage: a systematic review and meta-analysis.Revista brasileira de enfermagem · 2023Pooled it
- Intravenous versus oral iron for anaemia among pregnant women in Nigeria (IVON): an open-label, randomised controlled trial.The Lancet. Global health · 2024Trial
- Risk Factors and Postpartum Hemorrhage among Women with Vaginal Delivery.Annals of African medicine · 2026Observational
- Healthcare Providers' Practices in Postpartum Hemorrhage Management: A Multi-Centre Cross-Sectional Study in Tanzania.International journal of women's health · 2026Article
- Formative research to optimize pre-eclampsia risk-screening and prevention (PEARLS): study protocol.Reproductive health · 2025Article
- Quantitative Validation of Hematocrit Percentage Drop Cutoff Points in Postpartum Hemorrhage: An Automated Gravimetric Approach.Maternal-fetal medicine (Wolters Kluwer Health, Inc.) · 2025Article
- Postpartum Hemorrhage in Humanitarian Settings: Heat-Stable Carbetocin and Tranexamic Acid Implementation Study in Uganda.International journal of MCH and AIDS · 2024Article
- Postpartum Hemorrhage in Humanitarian Settings: Heat-Stable Carbetocin and Tranexamic Acid Implementation Study in South Sudan.International journal of MCH and AIDS · 2024Article
- Two Postpartum Blood Collection Devices: The Brass-V Drape and MaternaWell Tray-As Experienced by Birth Attendants and Birthing Women-A Questionnaire-Based Randomised Study.Obstetrics and gynecology international · 2024Article
- The AccuFlow sensor: a novel digital health tool to assess intrapartum blood loss at cesarean delivery.Journal of perinatal medicine · 2023Article
- Incidence of postpartum hemorrhage based on the improved combined method in evaluating blood loss: A retrospective cohort study.PloS one · 2023Article
- Visual estimation of blood loss versus quantitative blood loss for maternal outcomes related to obstetrical hemorrhage.Proceedings (Baylor University. Medical Center) · 2023Article
- Estimating blood loss during cesarean delivery: A comparison of methods.Journal of Taibah University Medical Sciences · 2022Article
- Detection and management of postpartum haemorrhage: Qualitative evidence on healthcare providers' knowledge and practices in Kenya, Nigeria, and South Africa.Frontiers in global women's health · 2022Article
- Multidisciplinary Programed Learning Simulation to Improve Visual Blood Loss Estimation for Obstetric Trauma Scenarios.Journal of advances in medical education & professionalism · 2022Article
- Accuracy of training blood volume quantification using a visual estimation tool.World journal of emergency medicine · 2021Article
- Postpartum hemorrhage: prevention, diagnosis and non-surgical management.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2020Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionImmediate postpartum haemorrhage (PPH) is the most common cause of maternal mortality worldwide. Most recommendations focus on its prevention and management. Visual estimation of blood loss is widely used for the early detection of PPH, but the most appropriate method remains unclear. This study aimed to compare the efficacy of visual estimation and objective measurement using a sterile under-buttock drape, to determine the volume of postpartum blood loss.
methodsThis study evaluated patients aged ≥ 18 years with low-risk term pregnancies, who delivered vaginally. Immediately after delivery, a birth attendant inserted the drape under the patient's buttocks. Postpartum blood loss was measured by visual estimation and then compared with objective measurement using the drape. All participants received standard intra- and postpartum care.
resultsIn total, 286 patients with term pregnancies were enrolled. There was a significant difference in postpartum blood loss between visual estimation and objective measurement using the under-buttock drape (178.6 ± 133.1 mL vs. 259.0 ± 174.9 mL; p < 0.0001). Regarding accuracy at 100 mL discrete categories of postpartum blood loss, visual estimation was found to be inaccurate, resulting in underestimation, with low correspondence (27.6%) and poor agreement (Cohen's kappa coefficient 0.07; p < 0.05), compared with objective measurement using the drape. Two-thirds of cases of immediate PPH (65.4%) were misdiagnosed using visual estimation.
conclusionVisual estimation is not optimal for measurement of postpartum blood loss in PPH. This method should be withdrawn from standard obstetric practice and replaced with objective measurement using the sterile under-buttock drape.
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Registered trials
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.