Postpartum haemorrhage remains an important consideration in maternity care, where early recognition of abnormal bleeding and an appropriate clinical response can be critical. One of the challenges facing maternity professionals is determining how much blood has actually been lost following childbirth. This is why objective postpartum blood loss measurement is becoming increasingly important within modern maternity environments.
Visual estimation has traditionally played a role in assessing blood loss, but estimating the volume of blood visually can be difficult, particularly when blood is mixed with amniotic fluid or other bodily fluids. Current World Health Organization (WHO) recommendations support objective measurement of postpartum blood loss, while calibrated collection drapes provide one method of collecting and quantifying fluid following vaginal birth.
The CETRO® Cover provides maternity professionals with a protective delivery-table cover incorporating a collection pocket and graduated measurement system. The transparent PE device enables collected bodily fluids to be observed and measured using graduations up to 2,000 ml.
This article explores why objective measurement matters, how postpartum blood loss is classified, the role of calibrated collection systems and how products such as the CETRO® Cover may support maternity teams.
Objective postpartum blood loss measurement means using a measurable method to determine the volume of blood lost following childbirth rather than relying solely on visual estimation.
A calibrated collection drape provides a physical means of collecting fluid and measuring its volume. This can provide healthcare professionals with quantifiable information that can be documented and considered alongside the patient’s clinical condition.
WHO updated its recommendations in 2023 in favour of objective measurement of postpartum blood loss to improve the detection and treatment of PPH in women experiencing vaginal birth. The supporting evidence considered by WHO included trials using calibrated blood-collection drapes.
This distinction is important. A calibrated drape measures collected fluid; it does not diagnose a patient’s condition independently.
Blood-loss measurements need to be interpreted alongside factors such as maternal observations, vital signs, symptoms, clinical assessment and local maternity protocols.
Following childbirth, clinicians may need to assess blood present on bedding, absorbent materials, the delivery surface and other areas.
Blood may also be mixed with amniotic fluid and other bodily fluids. These factors can make estimating a total volume visually challenging.
Objective measurement provides a numerical value that can complement professional clinical assessment.
WHO’s current approach places increased emphasis on objective quantification and early recognition of PPH. Its recommendations identify calibrated drapes as an objective method used in the evidence base for women following vaginal birth.
This does not remove the need for clinical judgement. Instead, measurement provides another piece of information to support it.
For UK maternity professionals, it is useful to understand how the Royal College of Obstetricians and Gynaecologists (RCOG) describes postpartum haemorrhage.
RCOG’s Green-top Guideline No. 52 describes the traditional definition of primary PPH as 500 ml or more of blood loss from the genital tract within 24 hours of birth.
It then classifies PPH as:
In other words, “moderate” does not mean that the haemorrhage has become less serious after reaching the major PPH threshold. Moderate and severe are subdivisions within the major PPH category.
This terminology is important when discussing calibrated blood-loss measurement because it helps maternity teams interpret measured volumes within an established clinical framework.
However, blood-loss volume should never be considered in isolation.
The 500 ml and 1,000 ml measurements have traditionally represented important reference points in the classification of primary PPH.
According to RCOG, primary PPH begins at 500 ml under its traditional definition. Between 500 and 1,000 ml it is classified as minor, while blood loss greater than 1,000 ml falls into the major PPH category.
RCOG’s patient information also explains that where heavy bleeding continues and blood loss exceeds 1,000 ml, senior hospital staff may become involved and additional interventions can be required depending on the patient’s condition.
These figures should not, however, be interpreted as meaning that clinicians simply wait until a particular volume is reached before taking action.
Clinical condition matters.
There has been an important development in international PPH guidance.
In October 2025, WHO, the International Federation of Gynecology and Obstetrics and the International Confederation of Midwives announced updated recommendations intended to support earlier diagnosis and treatment of PPH.
While 500 ml remains an important traditional threshold, clinicians are now also advised to act when objectively measured blood loss reaches 300 ml when accompanied by abnormal vital signs. WHO emphasises close monitoring following birth and objective measurement using calibrated drapes to support earlier detection.
This is particularly important when interpreting a graduated blood-collection device.
The number shown on the device is valuable information, but it forms part of a wider clinical picture. A lower measured volume accompanied by concerning physiological signs may be clinically significant.
This reinforces why objective measurement should complement rather than replace maternal observations and professional assessment.
A calibrated postpartum blood collection drape is designed to collect fluid following childbirth while providing graduations that enable the collected volume to be measured.
The principle is relatively simple:
Protect. Collect. Measure. Assess.
Instead of blood and fluid being dispersed across the delivery environment, the collection component provides a defined location where fluid can accumulate.
Graduations then provide an indication of collected volume.
WHO’s evidence review for objective measurement included calibrated blood collection drapes, and its guidance notes that the available evidence is largely derived from trials involving women who had vaginal births.
The CETRO® Cover 9606 is a single-use plastic cover intended for clinical use over delivery tables, incorporating an additional pocket for collecting bodily waste during childbirth.
Its design combines surface protection and fluid collection within one disposable product.
According to the product information available to Niche Healthcare, key characteristics include:
The transparent material also allows healthcare professionals to visually observe the collected fluid while using the graduations to establish a measurable volume.
The manufacturer’s instructions are intentionally straightforward.
Before use, the device protection should be inspected. The cover is then unfolded and placed onto the bed or appropriate delivery surface. The lined plastic pocket is prepared so that it remains open and positioned to collect liquid.
The practical photographs within Niche Healthcare’s CETRO® Cover specification material demonstrate how the product can be positioned around a maternity delivery bed, with the collection section extending below the patient area.
During use, collected fluid can enter the integrated collection area, allowing healthcare professionals to observe the graduated measurement scale.
The measured volume can then form part of the information considered during clinical assessment and documentation.
Following use, the manufacturer states that the medical device should be disposed of according to the respective hospital’s policy.
There is an important distinction between these two approaches.
Visual estimation relies upon healthcare professionals assessing blood and fluid present within the delivery environment and estimating the approximate volume.
Clinical experience remains extremely important, but determining volume visually can be difficult.
The CETRO® Cover physically collects fluid into a graduated area, providing a measurable value up to 2,000 ml.
Its purpose is not to replace the midwife’s or clinician’s judgement. Instead, it provides additional objective information that can be considered alongside clinical observations.
This makes the comparison less about:
“device versus clinician”
and more appropriately:
“visual assessment alone versus clinical assessment supported by objective measurement.”
That distinction is essential.
The CETRO® Cover may be particularly relevant for maternity departments evaluating ways to support more objective measurement following vaginal childbirth.
Potential healthcare environments include NHS maternity units, labour wards, obstetric departments, birth centres, private maternity hospitals and other clinical environments where appropriate postpartum blood-loss assessment takes place.
For procurement teams, the combined protective and collection design may also be worth considering when reviewing maternity consumables and standardising products across delivery environments.
The product should always be assessed against the organisation’s own clinical requirements, protocols and procurement procedures.
Clinical suitability should be the first consideration.
Procurement teams should establish whether the device is appropriate for the maternity team’s intended workflow and whether its measurement range is suitable for the proposed application.
The visibility and clarity of graduations are also relevant because the principal value of a calibrated collection system is its ability to provide useful measurable information.
Other considerations include:
Procurement decisions should consider overall clinical suitability and workflow value rather than unit price alone.
The manufacturer’s supplied instructions can be summarised simply:
Step 1 – Inspect
Inspect the device protection before use.
Step 2 – Unfold
Unfold the CETRO® Cover.
Step 3 – Position
Place the device onto the bed/delivery surface.
Step 4 – Prepare the collection pocket
Position the lined plastic pocket so that it is open and able to collect liquid.
Step 5 – Measure and clinically assess
The graduated collection area can support objective measurement of collected fluid. Measurements should be considered alongside maternal observations and clinical assessment.
Step 6 – Dispose
Following use, dispose of the device according to the healthcare organisation’s applicable hospital policy.
Healthcare professionals should always refer to the manufacturer’s current instructions for use and their organisation’s local procedures.
| Specification | Detail |
|---|---|
| Product | CETRO® Cover |
| Article number | 9606 |
| Application | Obstetrics |
| Material | Transparent PE plastic |
| Measurement capacity | Graduated up to 2,000 ml |
| Dimensions | Approx. 1,300 × 1,450 mm |
| Product weight | 140 g |
| Department packaging | 10 pieces |
| Transport packaging | 100 pieces |
| Transport packaging weight | 14 kg |
| Latex | Does not contain natural rubber latex |
| Sterility | Non-sterile |
| Re-use | Single use / do not re-use |
| Power requirements | Not applicable |
| Storage | Keep dry and away from sunlight |
| Shelf life | Use-by date applies; duration not specified in supplied information |
These specifications are derived from the supplied CETRO® Cover product information.
Used maternity consumables must be disposed of through the appropriate healthcare waste stream according to local policy.
NHS England’s HTM 07-01: Safe and sustainable management of healthcare waste provides national best-practice guidance concerning healthcare waste management.
The CETRO® Cover manufacturer specifically states that the device should be disposed of according to the respective hospital’s policy.
Where placental or other anatomical material requires containment or disposal, maternity teams should follow their organisation’s approved procedures.
Niche Healthcare can also supply associated maternity products, including maternity placenta bags and anatomical waste containers, allowing procurement teams to consider the wider post-delivery workflow alongside the blood collection system.
The CETRO® Cover incorporates a graduated collection area marked up to 2,000 ml. It enables healthcare professionals to collect bodily fluids and obtain measurable information that can support postpartum blood-loss assessment.
No. The device supports objective measurement of collected blood loss but does not independently diagnose PPH or determine treatment. Measurements must be considered alongside maternal observations, vital signs, clinical assessment and local maternity guidance.
Not necessarily. RCOG’s traditional definition identifies 500 ml or more as primary PPH. However, current WHO recommendations also advise action at 300 ml when accompanied by abnormal vital signs. Clinical condition therefore matters alongside measured volume.
“Major” is the overall category once blood loss exceeds 1,000 ml. RCOG then subdivides major PPH into moderate and severe categories. Moderate major PPH covers approximately 1,000–2,000 ml, while severe major PPH is above 2,000 ml.
No. The manufacturer’s product symbols specify that the device should not be reused. It is also identified as non-sterile and as not containing natural rubber latex.
Modern maternity care increasingly recognises that knowing how much blood has actually been collected can provide useful information during postpartum assessment.
WHO’s shift towards objective measurement is particularly significant. Its 2023 recommendations favour objective measurement following vaginal birth, while its 2025 guidance further emphasises early detection using measured blood loss alongside maternal vital signs.
For NHS maternity teams, calibrated collection systems can therefore be considered as part of a wider approach involving observation, clinical assessment, documentation, communication and appropriate escalation.
The CETRO® Cover provides one practical means of supporting objective postpartum blood loss measurement, combining a protective cover with an integrated graduated collection area up to 2,000 ml.
It should not be viewed as a diagnostic device or replacement for clinical judgement. Its value lies in providing healthcare professionals with another measurable piece of information at a time when accurate assessment can matter.
The product page should form part of a wider maternity-content ecosystem rather than standing alone.
Relevant internal links include:
Maternity Placenta Bag:
https://www.nicheofficesolutions.co.uk/product/maternity-placenta-bag/
10L Anatomical Waste Bin:
https://www.nicheofficesolutions.co.uk/product/anatomical-waste-bin-10l/
I would also link directly to the CETRO® Cover product page once published and create a broader maternity supplies or postpartum haemorrhage resource page to connect these products.
World Health Organization – Recommendations on the assessment of postpartum blood loss and use of a treatment bundle for postpartum haemorrhage:
WHO postpartum blood loss recommendations
Royal College of Obstetricians and Gynaecologists – Prevention and Management of Postpartum Haemorrhage, Green-top Guideline No. 52:
RCOG PPH guidance
NHS England – HTM 07-01: Safe and sustainable management of healthcare waste:
NHS England HTM 07-01
Accurate assessment of postpartum blood loss is an important part of safe and effective maternity care. While visual assessment and professional clinical judgement remain essential, objective postpartum blood loss measurement can provide healthcare professionals with measurable information to support assessment, documentation, communication and timely recognition of significant blood loss.
The CETRO® Cover offers a practical approach by combining a protective delivery-table cover with an integrated fluid collection system and graduated measurement up to 2,000 ml. Its transparent PE construction allows collected fluid to remain visible, while the graduated collection area provides an objective measurement that can be considered alongside maternal observations and wider clinical assessment.
Importantly, the CETRO® Cover should not be considered a diagnostic device or a replacement for clinical judgement. Blood-loss measurements should always be interpreted alongside the woman’s clinical condition, maternal observations and the healthcare organisation’s local maternity protocols.
For NHS maternity units, obstetric departments, birth centres and other healthcare providers reviewing their approach to postpartum blood loss assessment, calibrated collection systems provide an opportunity to reduce reliance on visual estimation alone and support a more consistent approach to measurement.
As maternity care continues to place greater emphasis on early recognition and objective assessment of postpartum blood loss, the CETRO® Cover provides a simple and practical solution designed to support healthcare professionals during childbirth.
For further information about the CETRO® Cover, product specifications, availability or NHS pricing, contact Niche Healthcare on 01274 965089.
Postpartum Blood Loss Measurement
CETRO Cover Specfication Sheet
Postpartum Blood Loss Measurement
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