MaternaWell Tray™

Blood loss before, during or after childbirth can occur rapidly. The loss of over 500 mL of blood after birth (or 1000 mL after a cesarean) is defined as a ‘postpartum hemorrhage.’ This complication leads to low blood pressure, shock and in some cases death. Though a rare event in individual facilities, cumulatively, PPH is a leading cause of maternal mortality worldwide.

Studies have shown that blood loss is consistently underestimated using visual assessment alone.  Continuous measurement of blood loss is increasingly understood to be important component of proper clinical management of birth.  By measuring blood loss from postpartum hemorrhage in a dedicated, calibrated device, clinicians can have earlier warning and definitive totals of blood lost in order to start emergency measures immediately and prevent escalation of the case.  

The current methods of quantitative measurement of blood loss include plastic calibrated drape. This method, sometimes called the BRASSS-V drape, is accurate.  However, the drape itself is single use plastic resulting in waste and making this option less sustainable.

The MaternaWell Tray was developed in South Africa by Dr. Justus Hofmeyr and manufactured by Umoya, a South African medical device company in partnership with Maternova.  The tray is mother-centric, affordable and reusable.  

The molded plastic MaternaWell Tray is designed with a tapered wedge to be placed under a woman’s buttocks while the adjacent wells catch the blood as it flows out of the body and allow continuous and quantitative monitoring of blood loss. 

The MaternaWell Tray has two wells, each with calibration markers at 300 mL and 500mL. The first well, flows over after filling to 500 mL into the second, meaning there is a clear visual signal at eye-level signaling that the total blood loss has moved over the 500 mL threshold. Then, the second well begins to fill up to 1000 mL in total.

A Training Video is linked for further education on this calibrated tool.

Product and ordering information

• Minimum quantity of 20 units per order
• English instructions available
• Not for sale within the United States for commercial use

Regulatory approval information

This device is approved for use in South Africa by SAHPRA.

FAQ:

Why was the MaternaWell Tray developed?

Dr. Justus Hofmeyr invented the MaternaWell Tray to ensure that women- no matter where they live - do not needlessly suffer or die during childbirth. Their “blood loss monitoring device” is poised to prevent mothers all over the world from dying from postpartum hemorrhage by reducing the critical time between blood loss and treatment

Justus Hofmeyr, MB BCh, MRCOG, DSc is a Professor of Obstetrics and Gynecology at the University of Botswana School of Medicine and Director of the Effective Care Research Unit, University of the Witwatersrand and Walter Sisulu University, East London, South Africa. He has dedicated his life’s work to improving maternal health outcomes for mothers living in low-resource settings. He has published over 350 articles in peer-reviewed journals.

Is the MaternaWell Tray already used with patients?

The MaternaWell Tray has been tested and is in multiple sites in South Africa as well as in Kenya, Liberia, Sierra Leone, Zimbabwe and Tanzania.  

Is the product suitable for low-resource settings?

The product was specifically developed for low-resource settings and developed with input from midwives in hospitals in South Africa, Kenya and Tanzania. Because it is re-usable the Tray is ideal for low-resource settings where the drape may be too expensive to ship and restock. 

The MaternaWell Tray is manufactured in South Africa by Umoya, our manufacturing partner.  

Is there enough evidence for the effectiveness of the MaternaWell Tray?

The evidence of the importance of continuous blood loss monitoring was cemented in the EMOTIVE trial. The MaternaWell Tray itself is in continuous use in several South African hospitals and increasingly used as the standard in South Africa.  

https://www.frontiersin.org/articles/10.3389/fgwh.2022.1020163/full

https://pubmed.ncbi.nlm.nih.gov/34227106/

https://umoya.org.za/wp-content/uploads/2023/05/Gallos-et-al-2023-Randomized-Trial-of-Early-Detection-and-Treatment-of-PPH.pdf

Has the accuracy of the tray been tested?

A formal test certificate is not currently available, largely due to practical limitations: in real-life usage, there exists a mix of clots, plasma and full blood going to a blood collection device,  and  devices can be positioned in slightly uneven surfaces. The value of the tray is in providing an accurate enough approximation to support timely clinical decision making. That said, the tray has been manufactured using precise digital 3D modeling, ensuring high consistency between units and precise objective calibration.  One peer-reviewed, independent evaluation of the tray found that the tray facilitated more accurate estimation of blood loss as compared to the drape (Esau et al).[1]

How accurate are the volume graduations?

The volume graduations were derived from CAD modeling with close tolerance and mold shrinkage correction. In-house tests have shown strong visual correlation with standard measuring cylinders when water is poured into the tray on a flat surface. Variability in fluid types (blood, amniotic fluid, clots) and surface angle in use means the tray is best used as an estimation tool (as will be drapes).

Testimonials

Here are the testimonials from midwives using the MaternaWell tray in South Africa:

"We are midwives…providing care to mother and newborns during and after delivery, managing complications that arise during any stage of labour to ensure good outcomes, complications including PPH. PPH is excessive bleeding after child birth; can be mild (500 - 1000), moderate (1000 - 2000ml) or severe (>2000)."

“Those MaternaWell Trays help us to determine 4 domains which are readiness; recognition; response as well as reporting PPH in order to manage patient better. They have numbers on them that give you correct measure of blood loss easily.”

“They are easy to use for the collection of blood loss and comfortable when placed correctly for patient, and because they are not enamel they are not cold for the patients.”

“The area of delivery is less messy because the tray collects all the blood and it does not flow onto the bed and the floor making it easy to clean post-delivery.”