Accurate estimation of blood loss during cesarean deliveries: A secondary analysis of a randomized controlled trial comparing visual, quantitative and calculated approaches

vEBL appears to grossly underestimate actual blood loss when compared with QBL and cEBL methods. Although the observed differences were not statistically significant, the wide confidence intervals suggest potential for substantial underestimation. Given this limitation, reliance solely on vEBL may lead to under-recognition and delayed management of PPH. Therefore, it is recommended that QBL and cEBL be incorporated into routine practice, particularly in high-risk cases. Clinicians should also account for factors that can influence EBL accuracy, such as operative duration and maternal BMI, when assessing blood loss and initiating interventions.