An Australian study evaluating a specialised blood collection drape to improve midwives' estimation of blood loss during labour.

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This pilot study aims to determine the accuracy of midwives' third stage labour blood loss estimations and the feasibility of a using a calibrated blood collection drape to measure third stage blood loss in the Australian setting. Australian clinicians tend to estimate third stage blood loss using visual estimation, which underestimates blood loss. Third stage blood loss, postpartum haemorrhage (PPH) and associated anaemia significantly contributes to serious postnatal health complications and maternal mortality. In Australia, PPH occurs in 6.8-9.2% of all births, with variation between states. However, Australian and overseas data has shown a trend increase in PPH and associated morbidity which have triggered a call for further research and improved management of the third stage of labour. One area that needs further research is blood loss estimation accuracy, as visual estimation of third stage blood loss leads to an under-diagnosis of PPH and poor identification of women at risk of complications from anaemia. Overseas researchers have piloted blood collection drapes, which have been found to be accurate for measuring third stage blood loss when compared to visual methods. No studies of the acceptability of these drapes have been conducted and they are untested in Australia. Furthermore, accuracy of Australian clinicians’ visual estimations has not been tested in the clinical setting. This study will compare the mean difference between clinician's visual estimation of third stage blood loss to third stage blood loss measured in a calibrated blood collection drape. Clinican's attitudes towards visual blood estimation and the acceptability of the drape will be surveyed. A cost benefit analysis will also be conducted. The results from this pilot study will inform the design of a multi-centre study involving a larger number of participants.

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