Objective: The study aimed at finding the mean blood loss following vaginal delivery using calibrated BRASSS-V drape, the average drop in haematocrit at 2hrs and 6hrs following vaginal delivery and the relationship between blood loss estimation using calibrated BRASSS-V drape and pre-weighed perineal pads.

Methods: One hundred eligible parturients were recruited for the study. Calibrated BRASSS-V drape was used to collect blood during vaginal delivery and the quantity read from the calibrated receptacle. Pre-weighed pads were used to collect remnants blood not directly collected by the drape, weighed and equivalence in volume added to that obtained from the drape. The haematocrit was determined at admission in labour after ruling out dehydration, repeated 2hours and 6 hours post-delivery.

Results: The mean value of blood loss following vaginal delivery using calibrated BRASSS-V drape estimation was 261mls and the mean haematocrit drop was 1.36% and 2.50% after 2hrs and 6hrs respectively. A correlation curve was plotted to determine the relationship between measured blood loss and haematocrit drop after 2hrs and 6hrs of delivery and the one at 6hrs correlated better (r=0.487 and r= 0.750 at 2hrs and 6hrs respectively).

Conclusion: There was a positive correlation between the measured blood loss at vaginal delivery and the drop in haematocrit with better correlation at 6hrs. The 6hrs haematocrit drop in well hydrated and selected parturients can be used to estimate blood loss at vaginal delivery in labour ward settings.

Keywords: Postpartum haemorrhage, BRASSS-V drape, Postpartum haematocrit

1. Starr A. The Safe Motherhood Agenda: Priorities for the Next Decade. New York: Inter-agency Group for Safe Motherhood, Family Care International, 1997.
2. Maine D. Safe Motherhood Programs: Options and Issues. Columbia University: Center for Population & Family Health, 1993:42.
3. Williams JW. The tolerance of freshly delivered women to excessive loss of blood. Am J ObstetGynecol 1919;90:1.
4. Duthie SJ, Ven D, Yung GL, Guang DZ, Chan SY, Ma HK. Discrepancy between laboratory determination and visual estimation of blood loss during normal delivery. Eur J ObstetGynecolReprodBiol 1990;38:119–24.
5. Kodkany BS, Derman RJ, Goudar SS, et al. Initiating a novel therapy in preventing postpartum hemorrhage in rural India: a joint collaboration between the United States and India. Int J Fertil Women Med 2004;49: 91–6.
6. Geller SE, Patel A, Naik VA, et al. Conducting international collaborative research in developing nations. Int J Gynaecol Obstet 2004;87: 267–71.
7. Khan KS, Wojdyla D, Say L, Gulmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet 2006;367:1066-74.
8. Ijaiya MA, Aboyeji AP, Abubakar D. Analysis of 348 consecutive cases of primary postpartum hemorrhage at a tertiary hospital in Nigeria. J Obstet Gynaecol 2003; 23(4): 374-377.
9. Fisher AA, Laing JE, Stoeckel J et al (eds). Sampling .In: Handbook for family planning operations research design. Population council. 1998: pp 40-48.
10. Ebeigbe PN, Gharoro EP. A raised mid-trimester blood pressure: Is it predictive of pregnancy Ind HTN in Nigeria pregnant women? Nig Postgraduate med J. 2004; 11 (4); 294-7.
11. Gharoro EP, Igbafe AA. Antenatal care; some characteristics of the booking visit in a major teaching hospital in the developing world. Med Sci Monitor 2000; 6 (3) 519-522.
12. Kodkany BS and Derman RJ. (eds). Pitfalls in assessing blood loss and decision to transfer. In B-Lynch C, Keith LG, Lalonde AB, et al (eds): A textbook of Postpartum hemorrhage. A comprehensive guide to evaluation, management and surgical intervention.Sapiens Publishing, 2006. Pgs 35-44.
13. Gharoro EP, Enabudoso EJ. Relationship between visually estimated blood loss at delivery and postpartum change in Hct. J ObstetGynaecol 2009; 29 (6); 517-20.
14. Umeora OU, Esike CO, Egwatu VE. Maternal mortality in rural Nigeria. Int J ObstGynecol, 2005; 88: 321-322.
15. Arowojolu AO. Managing Major Early (Primary) PPH in developing countries. Trop J Obstet Gynaecol 2003, 20: 144-152.
16. Mark EE, Douglas RD, Laurence ED. Correlation of transfusion volume to change in Hct. Am J of Hematology 2006 (81): 145-146.
17. Dzhurko BI. Correlation between hematocrit changes and the volume of circulating blood after haemorrhage. 1994: Patol Ficiol EkspTer 25-27
18. George H. Nelson, Susan Donnell BS, Gloria Griffin, Rose M. Nelson. Timing of Postpartum Haematocrit determinations. Southern Medical J. 1980; 73 (9): 1202-04.
19. Zwart J, Richters J, Öry F, de Vries J, Bloermenkamp K, van Roosmalen J. Severe maternal morbidity during pregnancy, delivery and puerperium in the Netherlands: a nationwide population-based study of 371 000 pregnancies. BJOG 2008;115:842-50.
20. Nicol B, Croughan Minihane M, Kilpatrick SJ. Lack of value of routine postpartum hematocrit determination after vaginal delivery. Obstet Gynecol. 1997; 90: 514-18.

Oke Oluwaseyi F

Department of Obstetrics and Gynaecology, LAUTECH Teaching Hospital Ogbomoso, Nigeria