Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb 4;9(2):e13428.
doi: 10.1016/j.heliyon.2023.e13428. eCollection 2023 Feb.

Design of a postpartum hemorrhage and transfusion risk calculator

Lissette A Gonzalez Carrillo  1 , Cristina Ruiz de Aguiar  2 , Jesús Martin Muriel  3 , Miguel A Rodriguez Zambrano  1
Affiliations

Design of a postpartum hemorrhage and transfusion risk calculator

Lissette A Gonzalez Carrillo et al. Heliyon. .

Abstract

Background: Postpartum hemorrhage is the major cause of maternal deaths due to childbirth and also responsible for maternal morbidity.

Objectives: In this study we set out to look the incidence of postpartum hemorrhage in our population, to identify the most important risk factors for postpartum hemorrhage and thus develop a predictive risk calculator for postpartum hemorrhage and transfusion.

Study design: data was taken from patients who presented vaginal delivery or cesarean section from January 1 to December 31, 2016, the variables taken into account as risk factors were as follows: Gestational age, history of chronic or gestational hypertension, preeclampsia, previous abortions, parity, previous cesarean section, placenta previa, labor time, and postpartum hemorrhage as the event of interest. An objective quantification was performed on a weight scale in grams for the estimation of bleeding, considering postpartum hemorrhage those with >500 ml in vaginal delivery and >1000 ml of blood loss in cesarean section. Subsequently, a predictive risk calculator was developed using the Naïve Bayes algorithm.

Results: A success rate of 58% was obtained in the identification of patients at high risk of hemorrhage, and 36% for transfusion, with a sensitivity of 50.7% and specificity of 64.06%, identifying as risk factors for postpartum hemorrhage gestational age between 35 and 40 weeks, hypertension and preeclampsia, previous cesarean section, duration of labor <1 h or more than 10 h, placenta previa and previous history of postpartum hemorrhage.

Conclusion: A postpartum hemorrhage risk calculator has been designed, which due to its improved accuracy after incorporation of data becomes a useful tool that will require a larger study population to improve its performance in clinical practice and more similar studies to validate it.

Keywords: Maternal morbidity; Maternal mortality; Postpartum hemorrhage; Puerperium; Risk calculation; Risk factors; Transfusion.

PubMed Disclaimer

Conflict of interest statement

Funding: We have not received financial support for the research. Employment: There is no organization that can gain or lose financially through the publication of this document. Personal financial interests: there are no personal financial interests with respect to any of the authors. Interests in institutional competence There are no institutions with financial interest or conflict regarding the topics discussed in this manuscript. Patient consent statement: Patient consent is not required because no personal information or details are included.

Figures

Fig. 1
Fig. 1
Number of women with actual PPH compared to that estimated by the risk calculator.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Kominiarek M.A., Kilpatrick S.J. Postpartum hemorrhage: a recurring pregnancy complication. Semin. Perinatol. 2007;31(3):159–166. doi: 10.1053/j.semperi.2007.03.001. - DOI - PubMed
    1. Carroli G., et al. Epidemiology of postpartum haemorrhage: a systematic review. Best Pract. Res. Clin. Obstet. Gynaecol. 2008;22(6):999–1012. doi: 10.1016/j.bpobgyn.2008.08.004. - DOI - PubMed
    1. AbouZahr C. Global burden of maternal death and disability. Br. Med. Bull. 2003;67:1–11. doi: 10.1093/bmb/ldg015. - DOI - PubMed
    1. Reale S.C., et al. Trends in postpartum hemorrhage in the United States from 2010 to 2014. Anesth. Analg. 2020;130(5):e119–e122. doi: 10.1213/ANE.0000000000004424. - DOI - PubMed
    1. Collaborators G.B.D.M.M. Global, regional, and national levels of maternal mortality, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1775–1812. doi: 10.1016/S0140-6736(16)31470-2. - DOI - PMC - PubMed

LinkOut - more resources