Postpartum Hemorrhage Following Cesarean Delivery in Women with a Scarred Uterus:A Retrospective Cohort Study

作     者：Bing-Nan Chen Di Wang Jia-Po Li Li-Yang Zhang Chong Qiao Bing-Nan Chen;Di Wang;Jia-Po Li;Li-Yang Zhang;Chong Qiao

作者机构：Department of Obstetrics and GynaecologyShengjing Hospital of China Medical UniversityShenyang 110004China Key Laboratory of Maternal-Fetal MedicineChina Medical UniversityShenyang 110004China Research Center of China Medical University Birth CohortShenyang 110004China 

出 版 物：《Reproductive and Developmental Medicine》 (生殖与发育医学（英文版）)

年 卷 期：2019年第3卷第4期

页      面：230-234页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：supported by the National Key R&D Program of China(2016YFC1000404) the National Natural Science Foundation of China(General Program 81370735) the National Natural Science Foundation of China(General Program 81771610) the Outstanding Scientific Fund of Shengjing Hospital(201706) 

主　　题：Cesarean Delivery Logistic Regression Postpartum Hemorrhage Prediction Risk Factors 

摘      要：Objective:To develop a model to predict the risk of postpartum hemorrhage(PPH)following cesarean delivery in women with a scarred ***:A total of 4,637 pregnant women with scarred uterus who underwent a cesarean delivery at a large hospital between January 2014 and December 2017 were *** women were divided into PPH(n=287)and non-PPH(n=4,350)groups.A model to predict PPH(blood loss≥1,000 mL within 24 h following cesarean delivery)was developed using multivariate logistic regression *** operating characteristic curve was drawn,and the area under curve(AUC)was ***:The incidence of PPH was 6.19%(287 of 4,637 women).Seven independent risk factors were associated with PPH:maternal age(odds ratio[OR]=1.42,95%confidence interval[CI]:1.02-1.97),previous gravidity(OR=1.24,95%CI:1.01-1.50),placental location(posterior wall of uterus,OR=0.69,95%CI:0.47-1.02;other locations,OR=1.21,95%CI:0.81-1.80),placenta previa(incomplete placenta previa,OR=10.51,95%CI:5.99-18.42;complete placenta previa,OR=31.65,95%CI:21.07-47.54),placenta accreta(OR=6.39,95%CI:4.02-10.16),hypertensive disorders of pregnancy(OR=2.27,95%CI:1.40-3.68),and fetal position(breech position,OR=2.07,95%CI:1.19-3.60;transverse position,OR=1.07,95%CI:0.48-2.41).A predictive model with AUC of 0.89 was developed(95%CI:0.86-0.91,P0.001).Conclusions:A model was developed to predict PPH following cesarean delivery in women with a scarred uterus.