ABSTRACT
【Objective】 To screen the risk factors of severe postpartum hemorrhage that can be found at 32 weeks of pregnancy through univariate and multivariate analysis and establish the risk prediction diagram. 【Methods】 A retrospective analysis was performed on pregnant women who gave birth and received blood transfusion in Women's Hospital of Nanjing Medical University from 2019 to 2021. According to the blood transfusion volume during and after operation, the patients were divided into low/moderate transfusion group (transfusion volume <2 000 mL) and massive-transfusion group (transfusion volume ≥2 000 mL), and the basic information of puerperal, single high risk factor, measures of operation and use of blood preparations were recorded. The differences of physiological and pathological factors between the low/moderate transfusion group and the massive transfusion group were analyzed by univariate analysis. Multivariate analysis and nomogram were performed on the statistically significant factors to calculate the consumption of blood components and hemostatic measures in the massive transfusion group. 【Results】 There were significant differences in age, number of pregnancies, advanced age at first delivery, history of abortion, scar uterus, pernicious placenta previa, placenta accreta, eclampsia/pre-eclampsia and acquired coagulopathy between the low/moderate transfusion group (n=930) and the massive transfusion group (n=108) (P<0.05), among which the number of pregnancies, advanced age for the first delivery, pernicious placenta previa, placenta accreta, and eclampsia/pre-eclampsia were independent risk factors for severe postpartum hemorrhage at 32 weeks of gestation. The scores of risk factors for massive blood transfusion from high to low were placenta accreta, primiparity at advanced age, eclampsia/pre-eclampsia, pernicious placenta previa, number of pregnancies≥4 and scar uterus. 【Conclusion】 The possibility of severe postpartum hemorrhage can be accurately evaluated in the third trimester (around 32 weeks) by univariate analysis, multivariate analysis and nomogram drawing. Among the puerpera underwent blood transfusion, the risk factors for massive hemorrhage included pregnancies ≥4 times, primiparity at advanced age, pernicious placenta previa, placenta accreta, and eclampsia/pre-eclampsia. The model based on these factors has a good prediction effect on massive hemorrhage.
ABSTRACT
Objective To study the value of C reactive protein (CRP) in the diagnosis of neonatal septicemia .Methods 60 cases of neonatal septicemia were selected as observation group ,at the same time ,60 cases of healthy newborns were selected as control group .The levels of CRP and WBC were detected ,and the blood culture was accessed .Drug sensitive test was progressed in infants with positive blood culture results .The diagnostic values of CRP ,WBC and CRP+ WBC were compared .Results In observation group ,there were 54 cases ,49 cases and 38 cases with positive results of blood culture and the detections of CRP and WBC ,respec‐tively .The accuracy of CRP+WBC was significantly higher than separate detections of CRP and WBC (P<0 .05) .The ROC AUC of CRP+WBC was 0 .852 1 ,which was higher than that of CRP and WBC .Conclusion CRP combined with WBC detection has certain clinical application value in diagnosis of neonatal septicemia .