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Probability of severe postpartum hemorrhage in repeat cesarean deliveries: a multicenter retrospective study in China

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单位: [1]Guangzhou Med Univ, Affiliated Hosp 3, Dept Obstet & Gynecol, Key Lab Major Obstet Dis Guangdong Prov, 63 Duobao Rd, Guangzhou 510150, Guangdong, Peoples R China [2]Guangdong Higher Educ Inst, Key Lab Reprod & Genet, Guangzhou, Peoples R China [3]Northwest Womens & Childrens Hosp, Dept Obstet & Gynecol, Xian, Peoples R China [4]Guangzhou Huadu Dist Maternal & Child Hlth Hosp, Dept Obstet & Gynecol, Guangzhou, Peoples R China [5]Zhengzhou Univ, Affiliated Hosp 1, Dept Obstet & Gynecol, Zhengzhou, Peoples R China [6]Huazhong Univ Sci & Technol, Tongji Med Coll, Tongji Hosp, Dept Obstet & Gynecol, Wuhan, Peoples R China [7]Peking Univ Third Hosp, Dept Obstet & Gynecol, Beijing, Peoples R China [8]Southern Med Univ, Nanfang Hosp, Dept Obstet & Gynecol, Guangzhou, Peoples R China [9]Xinjiang Med Univ, Affiliated Hosp 1, Dept Obstet & Gynecol, Urumqi, Peoples R China [10]Chongqing Med Univ, Affiliated Hosp 1, Dept Obstet & Gynecol, Chongqing, Peoples R China [11]Guangzhou Med Univ, Affiliated Hosp 2, Dept Obstet & Gynecol, Guangzhou, Peoples R China [12]Guangzhou Med Univ, Qingyuan Peoples Hosp, Affiliated Hosp 6, Dept Obstet & Gynecol, Guangzhou, Peoples R China [13]Peking Univ, Hlth Sci Ctr, Natl Hlth Commiss, Key Lab Reprod Hlth,Inst Reprod & Child Hlth, Beijing, Peoples R China
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To determine the factors predicting the probability of severe postpartum hemorrhage (SPPH) in women undergoing repeat cesarean delivery (RCD). This multicenter, retrospective cohort study involved women who underwent RCD from January 2017 to December 2017, in 11 public tertiary hospitals within 7 provinces of China. The all-variables model and the multivariable logistic regression model (pre-operative, operative and simple model) were developed to estimate the probability of SPPH in development data and external validated in validation data. Discrimination and calibration were evaluated and clinical impact was determined by decision curve analysis. The study consisted of 11,074 women undergoing RCD. 278 (2.5%) women experienced SPPH. The pre-operative simple model including 9 pre-operative features, the operative simple model including 4 pre-operative and 2 intraoperative features and simple model including only 4 closely related pre-operative features showed AUC 0.888, 0.864 and 0.858 in development data and 0.921, 0.928 and 0.925 in validation data, respectively. Nomograms were developed based on predictive models for SPPH. Predictive tools based on clinical characteristics can be used to estimate the probability of SPPH in patients undergoing RCD and help to allow better preparation and management of these patients by using a multidisciplinary approach of cesarean delivery for obstetrician.

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出版当年[2020]版:
大类 | 3 区 综合性期刊
小类 | 3 区 综合性期刊
最新[2025]版:
大类 | 3 区 综合性期刊
小类 | 3 区 综合性期刊
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出版当年[2019]版:
Q1 MULTIDISCIPLINARY SCIENCES
最新[2023]版:
Q1 MULTIDISCIPLINARY SCIENCES

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第一作者单位: [1]Guangzhou Med Univ, Affiliated Hosp 3, Dept Obstet & Gynecol, Key Lab Major Obstet Dis Guangdong Prov, 63 Duobao Rd, Guangzhou 510150, Guangdong, Peoples R China [2]Guangdong Higher Educ Inst, Key Lab Reprod & Genet, Guangzhou, Peoples R China
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通讯机构: [1]Guangzhou Med Univ, Affiliated Hosp 3, Dept Obstet & Gynecol, Key Lab Major Obstet Dis Guangdong Prov, 63 Duobao Rd, Guangzhou 510150, Guangdong, Peoples R China [2]Guangdong Higher Educ Inst, Key Lab Reprod & Genet, Guangzhou, Peoples R China
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