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