Pregnancy and Childbirth
Conditions
Interventions
Usual care with dissemination of the current guidelines
E MOTIVE care bundle
Sponsors
University of Birmingham
Eligibility
Sex/Gender
Female
Inclusion criteria
Inclusion criteria: Health facility is the randomisation unit. Health facilities are eligible for inclusion if they have 1000 to 5000 births a year and provide comprehensive obstetric care with ability to perform surgery for PPH.
Exclusion criteria
Exclusion criteria: Health facilities with pre-existing implementation of early detection or bundled approach are exclusion criteria
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcome is a composite of the following three clinical outcomes: 1) Number of women with primary severe PPH defined as blood loss =1000 ml following a vaginal birth in the facility; 2) Number of postpartum laparotomies for bleeding until discharge from the healthcare facility; 3) Number of postpartum maternal deaths from bleeding until discharge from the healthcare facility. | — |
Secondary
| Measure | Time frame |
|---|---|
| Number of women with laparotomy postpartum until discharge from the health facility;Number of women with laparotomy with compression sutures postpartum until discharge from the health facility;Number of women with laparotomy with arterial ligation postpartum until discharge from the health facility;Number of women with hysterectomy postpartum until discharge from the health facility;Number of women with hysterectomy for bleeding postpartum until discharge from the health facility;Rate of all cause maternal mortality postpartum until discharge from the health facility;Rate of all cause neonatal mortality postpartum until discharge from the healthcare facility;Blood loss (reported in ml, as a continuous variable);Number of women with primary PPH defined as blood loss =500 ml;Duration of hospitalisation postpartum;Duration of ICU hospitalisation postpartum;Number of women transferred to a higher-level facility postpartum until discharge from the health facility;Number of women receiving Non-pneumatic anti-shock garment (NASG) postpartum until discharge from the health facility;Number of women receiving uterine balloon tamponade postpartum until discharge from the health facility;Number of women receiving a blood transfusion postpartum until discharge from the health facility;Number of women receiving blood transfusion for postpartum haemorrhage until discharge from the health facility;Number of women admitted to Intensive Care Unit (ICU) until discharge from the health facility;PPH detection (with the following numerator and denominator: women who objectively had PPH (source-verified blood loss = 500 mL after weighing the drape) and were diagnosed with PPH by the birth attendants divided by the total number of women who objectively had PPH (source verified blood loss = 500 mL after weighing the drape);Compliance with MOTIVE bundle (with the following numerator and denominator: women who objectively had PPH and were treated with the PPH bundle following a diagnosis of P | — |
Countries
Kenya, Nigeria, South Africa, Tanzania
Contacts
Public ContactAdam Devall
Associate Professor
Outcome results
None listed