THUMB care package to reduce bleeding during and after caesarean section

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This is a cluster quality-improvement project that introduces a five-element bundled response (the Rule of THUMB) and linked risk assessments to improve early diagnosis and treatment of haemorrhage during and after caesarean section. Each participating hospital will collect two weeks of baseline usual-care data, then complete a co-design and training period (2–6 weeks) before implementing the intervention for two weeks. The intervention mandates preoperative and postoperative risk assessments, intraoperative and rapid postoperative bleeding checks, activation of a THUMB checklist when bleeding is identified, and scheduled early ward review for high-risk patients. The study also includes a process evaluation to understand contextual and socio-dynamic factors that influence how the intervention works in practice and to inform future scale-up across African settings.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Any patient who requires a caesarean section in participating countries with hospitals that routinely perform caesarean section.

Exclusion Criteria:

* Patients who opt out of the trial will be excluded.

Where it's running

• Mowbray Maternity Hospital
  Cape Town, South Africa Recruiting

Study contacts

• Principal investigator: BRUCE BICCARD, PhD — University of Cape Town
• Study coordinator: MARGOT FLINT, PhD
• Email: margot.flint@uct.ac.za
• Phone: 00274045001

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.