ArticleBMC pregnancy and childbirth2020
Incidence of postpartum haemorrhage defined by quantitative blood loss measurement: a national cohort.
Article in BMC pregnancy and childbirth, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- Pooled it
- Reproductive health and hemostatic issues in women and girls with congenital factor VII deficiency: A systematic review.Journal of thrombosis and haemostasis : JTH · 2022Pooled it
- Trends in postpartum hemorrhage, associated risk factors, and severe maternal outcomes in a multihospital health system, 2016-2023: a retrospective cohort study.American journal of obstetrics & gynecology MFM · 2026Article
- Article
- Prevalence, characteristics, and outcomes of postpartum hemorrhage in a tertiary hospital in Tigray, Northern Ethiopia (2017-2021): retrospective descriptive study.BMC pregnancy and childbirth · 2026Article
- Accuracy of Blood Loss Estimation and Identification of Factors Contributing to Early Postpartum Hemorrhage Following Vaginal Delivery.Journal of clinical medicine · 2026Article
- Cesarean section trends in Barrero, Dominican Republic: a community-level analysis of rates, risk factors, and patient motivations.Frontiers in global women's health · 2026Article
- Management practices of primary postpartum hemorrhage among traditional birth attendants: a qualitative survey, Iganga, Uganda.African health sciences · 2025Article
- Dynamics of Cytokines and Chemokines During the Peripartum Period in People Living With Human Immunodeficiency Virus.American journal of reproductive immunology (New York, N.Y. : 1989) · 2025Observational
- Postpartum hemorrhage: risk factors for severe blood loss, surgical intervention and peripartum hysterectomy.Archives of gynecology and obstetrics · 2025Article
- Epidural labor analgesia is a potential risk factor for increased blood loss within two hours after delivery in women with gestational hypertension: a retrospective cohort study.BMC pregnancy and childbirth · 2025Article
- Prevalence, emerging aetiologies, and contemporary predictors of primary postpartum haemorrhage in a tertiary-level obstetric population in Nnewi, Nigeria: a pilot study.Kronika (Ljubljana, Slovenia) · 2025Article
- Incidence, Causes and Outcomes of Postpartum Hemorrhage in Eastern Ethiopia: A Multicenter Surveillance Study.Maternal and child health journal · 2024Article
- Article
- Peripartum Haemorrhage: Haemostatic Aspects of the Updated Peripartum Haemorrhage Guideline of the German-Speaking Countries.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2023Review
- Hemodynamic Effects of Oxytocin and Carbetocin During Elective Cesarean Section in Preeclamptic Patients Under Spinal Anesthesia: A Randomized Double-blind Controlled Study.Anesthesiology and pain medicine · 2023Article
- Article
- Major obstetric haemorrhage.BJA education · 2022Review
- Effectiveness of emergency obstetric care training at the regional level in Ukraine: a non-randomized controlled trial.BMC pregnancy and childbirth · 2022Article
- A comprehensive digital phenotype for postpartum hemorrhage.Journal of the American Medical Informatics Association : JAMIA · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 7 institutions in 2 countries.
Funding
Abstract
backgroundVisual estimation of blood loss following delivery often under-reports actual bleed volume. To improve accuracy, quantitative blood loss measurement was introduced for all births in the 12 hospitals providing maternity care in Wales. This intervention was incorporated into a quality improvement programme (Obstetric Bleeding Strategy for Wales, OBS Cymru). We report the incidence of postpartum haemorrhage in Wales over a 1-year period using quantitative measurement.
methodsThis prospective, consecutive cohort included all 31,341 women giving birth in Wales in 2017. Standardised training was cascaded to maternity staff in all 12 hospitals in Wales. The training comprised mock-scenarios, a video and team drills. Uptake of quantitative blood loss measurement was audited at each centre. Data on postpartum haemorrhage of > 1000 mL were collected and analysed according to mode of delivery. Data on blood loss for all maternities was from the NHS Wales Informatics Service.
resultsBiannual audit data demonstrated an increase in quantitative measurement from 52.1 to 87.8% (P < 0.001). The incidence (95% confidence intervals, CI) of postpartum haemorrhage of > 1000 mL, > 1500 mL and > 2000 mL was 8.6% (8.3 to 8.9), 3.3% (3.1 to 3.5) and 1.3% (1.2 to 1.4), respectively compared to 5%, 2% and 0.8% in the year before OBS Cymru. The incidence (95% CI) of bleeds of > 1000 mL was similar across the 12 hospitals despite widely varied size, staffing levels and case mix, median (25th to 75th centile) 8.6% (7.8-9.6). The incidence of PPH varied with mode of delivery and was mean (95% CI) 4.9% (4.6-5.2) for unassisted vaginal deliveries, 18.4 (17.1-19.8) for instrumental vaginal deliveries, 8.5 (7.7-9.4) for elective caesarean section and 19.8 (18.6-21.0) for non-elective caesarean sections.
conclusionsQuantitative measurement of blood loss is feasible in all hospitals providing maternity care and is associated with detection of higher rates of postpartum haemorrhage. These results have implications for the definition of abnormal blood loss after childbirth and for management and research of postpartum haemorrhage.
Indexed as
Identifiers
What OpenQuestion holds
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.