Risk Score for Prediction of Postpartum Hemorrhages in Normal Labor at Chonburi Hospital
Sittiparn, W.; Siwadune, T.
Journal of the Medical Association of Thailand 100(4): 382-388
2017
ISSN/ISBN: 0125-2208 PMID: 29911829 Document Number: 17512
Postpartum hemorrhage (PPH) is major cause of morbidity and mortality globally. Although the majority of PPH could be avoided through the use of pharmacologic prevention during the third stage of labor, the maternal mortality rate from PPH is unchanged and the blood transfusion rate is increasing. In rural hospital or primary care unit, most health care workers are general practitioners and intern doctors, they are inexperienced in managing PPH case and lack of medication, blood component, medical instrument, and surgical team. Most deaths are from delay and incorrect treatment in the primary hospital. Thus, early detection of PPH could decrease maternal morbidity and mortality. To develop a risk score based on maternal clinical characteristics and medical history for prediction of postpartum A retrospective cohort study reviewed the medical charts for normal labor between September 1, 2012 Among 650 women, advanced maternal age, body mass index before pregnancy, pregnancy induced hypertension and diabetes mellitus types 2 were significantly associated with PPH in normal labor. These factors were incorporated into a risk score that could be predicted PPH in normal labor with sensitivity 81.3% and specificity 50.8% at optimal cut-off score equal or greater than 4. Applying developed PPH risk score is a practical way to identify patients who are at high-risk for developing PPH for an early detection, treatment, and transfer.
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