Brass-V Drape and MaternaWell Tray may aid in early recognition of PPH, reveals research
Postpartum haemorrhage is the leading cause of preventable maternal mortality worldwide. Early identification and prompt management of postpartum haemorrhage improve outcomes. Objective assessment of postpartum blood loss is an important step in identifying postpartum haemorrhage. The Brass-V drape and MaternaWell tray have been designed for routine measurement of postpartum blood loss. The perceived utility and acceptability of these devices to the parturients and birth attendants still begged exploring.
The Brass-V drape™ has shown great promise for use in LMIC, and its accuracy is proven with a 29–33% higher blood loss measurement compared to visual estimation. The blood collection drape consists of a funnelled and calibrated collecting pouch attached to a plastic sheet which is placed under the woman’s buttocks immediately after birth. Two belts attached to the upper end of the drape are tied around the woman’s abdomen, and the sheet folds out to collect the placenta and blood loss. The MaternaWell tray™ (Maternova, Inc.) is a novel reusable tray in which blood loss is collected in a visible, calibrated 500 ml receiver for real-time monitoring and overflows to a second receiver alerts to PPH. The wedge is slipped under the parturient’s buttocks so that her perineum is over the first calibrated receiver (similar to a “slipper” bedpan).
To assess the perceived usefulness and ease of use of a Brass-V drape versus a MaternaWell tray for the collection of postpartum blood loss. Authors conducted a prospective parallel randomised trial, employing a questionnaire to assess the experiences of birth attendants and birthing women who used these devices. The study was conducted at site B midwife obstetric unit in Khayelitsha Cape Town. Pregnant women presenting in early labour were approached for voluntary participation. After informed consent was obtained, participants were randomly assigned to the Brass-V drape or the MaternaWell tray, which the birth attendant placed after the birth of the baby.
There were 63 participants, of which 33 were assigned to the MaternaWell tray and 30 to the Brass-V drape. Birth attendants indicated a desire to use the MaternaWell tray (30 (90%)) or Brass-V drape (26 (87%)) in future deliveries. The parturients were also in favour of the future use of MaternaWell tray (33 (100%)) and Brass-V drape (28 (93%)). Ease of measurement favoured the Brass V-drape, and ease of placement favoured the MaternaWell tray. Five (8%) participants experienced postpartum haemorrhage, two with the MaternaWell tray and three with the Brass-V drape. One parturient required hospital transfer.
The aim was to assess and compare the utility and ease of use of the Brass-V drape and the MaternaWell tray for the collection of postpartum blood loss. Both devices were well-received by the birth attendants and parturients, with no statistical difference found between the two devices. Ease of measurement favoured the Brass-V drape with its calibrations making direct measurement possible. The blood collected in the MaternaWell tray was poured into a measuring jug to confirm the volume. In clinical use, the calibrations on the tray itself are used for monitoring. Ease of placement favored the MaternaWell tray. The Brass-V drape needs to be tied around the abdomen, making it cumbersome. Neither of these differences was statistically signifcant.
Both the MaternaWell tray and the Brass-V drape were perceived as acceptable and useful to the birth attendants and parturients. Both devices will lead to prompt and accurate diagnosis of postpartum blood loss. The MaternaWell tray shows promise for LMIC as it is reusable, affordable, and environmentally friendly. Its use in women with specific risk factors, such as obesity, needs further investigation. The perceived utility and ease of use of the Brass-V drape and the MaternaWell tray justify further research to determine the accuracy of blood loss quantification and the impact of monitoring and treatment bundles in both high- and low-risk participants.
Source: Jade Esau et al.; Wiley Obstetrics and Gynecology International Volume 2024, Article ID 6605833, 7 pages https://doi.org/10.1155/2024/6605833
