Analysis of risk factors of postpartum hemorrhage and application value of predictive score of postpartum hemorrhage / 天津医药

ABSTRACT

Objective To explore the risk factors of postpartum hemorrhage and the application value of predicting score of postpartum hemorrhage. Methods A total of 126 cases of postpartum hemorrhage hospitalized in our hospital from January 2013 to December 2016 were included in observation group, and 674 puerperae without postpartum hemorrhage were used as the control group. Data of the gestational age, delivery time, delivery mode and fetal weight were investigated, and the predictive scores of postpartum hemorrhage were compared between the two groups. Logistic regression analysis was carried out on influencing factors of postpartum hemorrhage. The value of postpartum hemorrhage prediction score in diagnosing postpartum hemorrhage was evaluated by ROC curve. Results The proportions of patients ≥35 years old, BMI≥24 kg/m2, the number of abortion≥2 times, production time≥2 times, cesarean section, fetal weight≥4000 g and pregnancy rates were 44.44%, 47.62%, 40.48%, 44.44%, 64.29%, 43.65%and 66.67%in observation group, which were significantly higher than those of control group (P<0.05). The predictive score of postpartum hemorrhage was higher in observation group than that in control group[(6.83 ± 1.25) points vs. (2.01 ± 0.98) points, t=48.356, P<0.01]. Logistic regression analysis showed that the fetal weight ≥ 4000 g, cesarean section, patients with pregnancy complications and abortion≥2 times were risk factors of postpartum hemorrhage (OR=4.195, 7.553, 5.596 and 7.192, P<0.05). Prediction of postpartum hemorrhage ROC curve AUC was 0.657 evaluated by postpartum prediction scale, and when the total score ≥4 points, the sensitivity of predicting postpartum hemorrhage was 81.25%, specificity was 65.55%. Conclusion Postpartum hemorrhage is related to fetal birth weight, cesarean section, pregnancy complications and the number of abortions. The predictive score of postpartum hemorrhage is expected to be an effective tool for predicting postpartum hemorrhage in clinical practice.