• Shubha Ambardekar, Tara Shochet, Hillary Bracken, Kurus Coyaji, and Beverly Winikoff.
• Gynuity Health Projects, New York, NY, USA. tshochet@gynuity.org.
• Bmc Pregnancy Childb. 2014 Aug 15; 14: 276.

BackgroundTrials of interventions for PPH prevention and treatment rely on different measurement methods for the quantification of blood loss and identification of PPH. This study's objective was to compare measures of blood loss obtained from two different measurement protocols frequently used in studies.MethodsNine hundred women presenting for vaginal delivery were randomized to a direct method (a calibrated delivery drape) or an indirect method (a shallow bedpan placed below the buttocks and weighing the collected blood and blood-soaked gauze/pads). Blood loss was measured from immediately after delivery for at least one hour or until active bleeding stopped.ResultsSignificantly greater mean blood loss was recorded by the direct than by the indirect measurement technique (253.9 mL and 195.3 mL, respectively; difference = 58.6 mL (95% CI: 31-86); p < 0.001). Almost twice as many women in the direct than in the indirect group measured blood loss > 500 mL (8.7% vs. 4.7%, p = 0.02).ConclusionsThe study suggests a real and significant difference in blood loss measurement between these methods. Research using blood loss measurement as an endpoint needs to be interpreted taking measurement technique into consideration.Trial RegistrationThis study has been registered at clinicaltrials.gov as NCT01885845.

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