Randomized Trial of Early Detection and Treatment of Postpartum Hemorrhage
Primary resultResult — go to the resultRelative risk 0.40 95% CI 0.32–0.50Authors' conclusion
Early detection of postpartum hemorrhage and use of bundled treatment led to a lower risk of the primary outcome, a composite of severe postpartum hemorrhage, laparotomy for bleeding, or death from bleeding, than usual care among patients having vaginal delivery.
Study context
- Population
- Patients having vaginal delivery in 80 secondary-level hospitals in Kenya, Nigeria, South Africa and Tanzania
- Participants
- 210,132 patients · 80 hospitals
- Comparison
- Early detection and first-response treatment bundle vs usual care
- Primary endpoint
- Composite of:
- Severe PPH (blood loss ≥1000 ml)
- Laparotomy for bleeding
- Maternal death from bleeding
Methodological detailsinternational, multicomponent intervention
- International
- Multicomponent intervention
Primary result
As reported in the abstract
Relative risk
0.40
95% CI 0.32–0.50
P < 0.001
By group
Intervention vs Usual care
RR 0.40 (95% CI 0.32–0.50); P < 0.001
Further findings
| Outcome | Intervention | Usual care | Rate ratio (95% CI) | |
|---|---|---|---|---|
| Detection of PPH | 93.1% | 51.1% | 1.58 (1.41–1.76) | |
| Adherence to treatment bundle | 91.2% | 19.4% | 4.94 (3.88–6.28) | |
| 0.10.31310Rate ratio (log scale) |
Original publication
Randomized Trial of Early Detection and Treatment of Postpartum Hemorrhage. N Engl J Med. Published 9 May 2023. doi:10.
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