Association between graded subchorionic hematoma and adverse pregnancy outcomes in singleton pregnancies: a prospective observational cohort study.

OBJECTIVE: To investigate whether different grades of subchorionic hematoma (SCH) are involved in the timing of birth and the development of adverse pregnancy outcomes in singleton pregnant women. METHODS: A total of 171 women with singleton pregnancies, 72 of whom had SCH before 20 weeks and between 12 and 20 weeks of gestational age (GA), were included in this study conducted between January 2018 and December 2021. These patients were divided into three subgroups based on the size of the subchorionic hematoma on ultrasound imaging. Baseline demographic data, obstetric outcomes, and risk factors for subchorionic hematoma were compared for the two groups. RESULTS: A higher number of pregnancies from the SCH group resulted in miscarriage (30.56% versus 2.02%, p < 0.0001), early preterm birth (8.33% versus 1.01%, p = 0.0035), premature rupture of membranes (15.28% versus 4.04%, p = 0.0103), fetal growth restriction (9.72% versus 0%, p = 0.0015), and delivery 13.18 days earlier (274.34 ± 11.25 versus 261.16 ± 29.80, p = 0.0013) than those from the control group. Compared with SCH detected before 12 weeks of GA, the rate of miscarriage increased, and the live birth rate decreased significantly in patients with SCH caught between 12 and 20 weeks of GA. With the increase in hematoma size, the likelihood of miscarriage increased significantly. Further analysis found that delivery occurred earlier in the medium/large SCH group (271.49 ± 23.61 versus 253.28 ± 40.68/261.77 ± 22.11, p = 0.0004/0.0073) but not in the small SCH group (274.34 ± 11.25 versus 267.85 ± 21.01, p = 0.2681) compared to the control group. Our results also showed that the anterior placenta (52.04% versus 33.33%, p = 0.0005, OR = 0.3137, 95% CI [0.1585, 0.601]) is a protective factor for subchorionic hematoma. CONCLUSION: Our study shows that women with SCH are at a higher risk of adverse pregnancy outcomes and are independently associated with miscarriage, early preterm birth, premature rupture of membranes, and fetal growth restriction. A subchorionic hematoma, especially detected between 12 and 20 weeks of GA, is very likely to cause miscarriage or preterm birth in women with a medium or large subchorionic hematoma.

Comparison and Validation of Different Risk Assessment Models in Patients with Venous Thromboembolism During Pregnancy and Postpartum: A Retrospective Study in China.

Introduction: Venous thromboembolism (VTE) causes maternal mortality and morbidity. This study compares the predictive performance of three risk assessment models (Caprini model, Wells Score, and RCOG model) for VTE risk in Chinese patients during pregnancy and postpartum. Materials and Methods: We conducted a retrospective study in Nanfang Hospital of Southern Medical University and the Third Affiliated Hospital of Guangzhou Medical University from January 2003 to January 2022. Patients were risk-classified using the three risk assessment models, and the models were evaluated for accuracy. Results: A total of 302 patients with confirmed VTE during pregnancy and postpartum were identified. Of these, 142 (47.0%) were diagnosed during pregnancy and 160 (53.0%) postpartum. A total of 276 (91.4%) patients had DVT only, 14 (4.6%) had PE only, and 12 (4.0%) were diagnosed with both. Of the 142 antepartum patients, 140 were categorized at moderate or above-risk levels by the Caprini model, 134 in the Wells Score model, and 112 in the RCOG model, respectively. The number of postpartum patients at moderate or above-risk levels identified by the Caprini, Wells Score, and RCOG models were 160, 152, and 118. The Caprini model significantly stratified VTE patients into a moderate or high-risk level (p < 0.05, Friedman Test). The Caprini model was also more effective at assessing the risk of VTE among postpartum patients than antepartum patients (p < 0.05, Friedman Test). Conclusion: We have demonstrated that the Caprini model is an effective prediction tool for the maternal population during peripartum, especially in the postpartum period. Results from the Caprini model will help obstetricians or physicians stratify potential risk patients and guide prophylaxis decisions. The RCOG model was not particularly useful in Chinese VTE patients during pregnancy and postpartum. Multicenter prospective validations of the RCOG model in Chinese maternal populations are needed.

Linguistic neutrosophic power Muirhead mean operators for safety evaluation of mines.

Safety is the fundamental guarantee for the sustainable development of mining enterprises. As the safety evaluation of mines is a complex system engineering project, consistent and inconsistent, even hesitant evaluation information may be contained simultaneously. Linguistic neutrosophic numbers (LNNs), as the extensions of linguistic terms, are effective means to entirely and qualitatively convey such evaluation information with three independent linguistic membership functions. The aim of our work is to investigate several mean operators so that the safety evaluation issues of mines are addressed under linguistic neutrosophic environment. During the safety evaluation process of mines, many influence factors should be considered, and some of them may interact with each other. To this end, the Muirhead mean (MM) operators are adopted as they are powerful tools to deal with such situation. On the other hand, to diminish the impacts of irrational data provided by evaluators, the power average (PA) operators are under consideration. Thus, with the combination of MM and PA, the power MM operators and weighted power MM operators are proposed to aggregate linguistic neutrosophic information. Meanwhile, some key points and special cases are studied. The advantages of these operators are that not only the interrelations among any number of inputs can be reflected, but also the effects of unreasonable information can be reduced. Thereafter, a new linguistic neutrosophic ranking technique based on these operators is developed to evaluate the mine safety. Moreover, in-depth discussions are made to show the robust and flexible abilities of our method. Results manifest that the proposed method is successful in dealing with mine safety evaluation issues within linguistic neutrosophic circumstances.

Linguistic neutrosophic Hamacher aggregation operators and the application in evaluating land reclamation schemes for mines.

Land reclamation has become a significant way for the improvement of ecological environment in mining areas. When selecting the optimal land reclamation scheme, LNNs (linguistic neutrosophic numbers) are suitable to describe the complex fuzzy evaluation information through linguistic truth, indeterminacy and falsity membership degrees. Furthermore, the Hamacher aggregation operators are good tools to handle multi-criteria decision making problems. Accordingly, the aim of this paper is to extend Hamacher aggregation operators with LNNs and then build a decision making framework for evaluating land reclamation schemes in mining areas. First, new operational laws of LNNs based on Hamacher t-norm and t-conorm are defined. Then, several linguistic neutrosophic Hamacher aggregation operators, including the linguistic neutrosophic Hamacher weighted mean aggregation operators and linguistic neutrosophic Hamacher hybrid weighted mean aggregation operators are developed. Meanwhile, their desirable properties are proved. Thereafter, a method for decision making with linguistic neutrosophic information based on these operators is proposed to deal with complex decision problems. At last, the validity of this method is confirmed by an illustrative example of evaluating the land reclamation schemes in mining areas. In addition, the impact of the parameter in extended Hamacher aggregation operators is discussed. The merits of the proposed method are also highlighted by comparing with other decision making methods. The results show that the proposed linguistic neutrosophic Hamacher aggregation operators have great flexibility and advantages, and can provide powerful ways for the evaluation of land reclamation schemes.