Identifying women most likely to benefit from prevention strategies for postpartum hemorrhage
Objective: To identify women who are most likely to benefit from primary prevention strategies for postpartum hemorrhage (PPH). Study Design: In a retrospective patient cohort, we applied recursive partitioning algorithms to identify the most discriminant risk factors and their interactions, and cal...
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| Veröffentlicht in: | Journal of perinatology 2009-06, Vol.29 (6), p.422-427 |
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| container_title | Journal of perinatology |
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| creator | Lu, M C Korst, L M Fridman, M Muthengi, E Gregory, K D |
| description | Objective:
To identify women who are most likely to benefit from primary prevention strategies for postpartum hemorrhage (PPH).
Study Design:
In a retrospective patient cohort, we applied recursive partitioning algorithms to identify the most discriminant risk factors and their interactions, and calculated the ‘number needed to treat’ to prevent a single case of PPH (estimated blood loss >1000 ml).
Result:
By delivery category, the highest risk groups with ‘number needed to treat’ ranging from 4 to 7 were: (1) vaginal delivery (PPH=0.7% of 16 218)—macrosomia with gestational diabetes and manual removal of the placenta; (2) primary cesarean (PPH=18.7% of 2696)—macrosomia and multiparity; and (3) repeat cesarean (PPH=16.0% of 1832)—uterine incision other than low transverse and failed vaginal birth after cesarean.
Conclusion:
Clinical profiles that identify women at risk for PPH can provide a foundation for the development of primary prevention strategies. |
| doi_str_mv | 10.1038/jp.2009.2 |
| format | Article |
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To identify women who are most likely to benefit from primary prevention strategies for postpartum hemorrhage (PPH).
Study Design:
In a retrospective patient cohort, we applied recursive partitioning algorithms to identify the most discriminant risk factors and their interactions, and calculated the ‘number needed to treat’ to prevent a single case of PPH (estimated blood loss >1000 ml).
Result:
By delivery category, the highest risk groups with ‘number needed to treat’ ranging from 4 to 7 were: (1) vaginal delivery (PPH=0.7% of 16 218)—macrosomia with gestational diabetes and manual removal of the placenta; (2) primary cesarean (PPH=18.7% of 2696)—macrosomia and multiparity; and (3) repeat cesarean (PPH=16.0% of 1832)—uterine incision other than low transverse and failed vaginal birth after cesarean.
Conclusion:
Clinical profiles that identify women at risk for PPH can provide a foundation for the development of primary prevention strategies.</description><identifier>ISSN: 0743-8346</identifier><identifier>EISSN: 1476-5543</identifier><identifier>DOI: 10.1038/jp.2009.2</identifier><identifier>PMID: 19177146</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>Algorithms ; Cesarean section ; Cesarean Section, Repeat - adverse effects ; Childbirth & labor ; Diabetes mellitus ; Female ; Fetal Macrosomia ; Gynecology ; Health aspects ; Hemorrhage ; Hospitals ; Humans ; Hysterectomy ; Maternal mortality ; Medical Audit ; Medicine ; Medicine & Public Health ; Obstetrics ; Odds Ratio ; original-article ; Pediatric Surgery ; Pediatrics ; Physiology ; Placenta ; Postpartum ; Postpartum Hemorrhage - etiology ; Postpartum Hemorrhage - prevention & control ; Pregnancy ; Pregnancy, Complications of ; Prevention ; Retrospective Studies ; Risk analysis ; Risk Factors ; Risk groups ; Uterus ; Vagina ; Women ; Womens health</subject><ispartof>Journal of perinatology, 2009-06, Vol.29 (6), p.422-427</ispartof><rights>Springer Nature America, Inc. 2009</rights><rights>COPYRIGHT 2009 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group Jun 2009</rights><rights>Nature Publishing Group 2009.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c471t-c7d2c5ad42dd6a220f0873953c15012a27f58ac9bd92a1a4336866915e93d8003</citedby><cites>FETCH-LOGICAL-c471t-c7d2c5ad42dd6a220f0873953c15012a27f58ac9bd92a1a4336866915e93d8003</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/jp.2009.2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/jp.2009.2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19177146$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lu, M C</creatorcontrib><creatorcontrib>Korst, L M</creatorcontrib><creatorcontrib>Fridman, M</creatorcontrib><creatorcontrib>Muthengi, E</creatorcontrib><creatorcontrib>Gregory, K D</creatorcontrib><title>Identifying women most likely to benefit from prevention strategies for postpartum hemorrhage</title><title>Journal of perinatology</title><addtitle>J Perinatol</addtitle><addtitle>J Perinatol</addtitle><description>Objective:
To identify women who are most likely to benefit from primary prevention strategies for postpartum hemorrhage (PPH).
Study Design:
In a retrospective patient cohort, we applied recursive partitioning algorithms to identify the most discriminant risk factors and their interactions, and calculated the ‘number needed to treat’ to prevent a single case of PPH (estimated blood loss >1000 ml).
Result:
By delivery category, the highest risk groups with ‘number needed to treat’ ranging from 4 to 7 were: (1) vaginal delivery (PPH=0.7% of 16 218)—macrosomia with gestational diabetes and manual removal of the placenta; (2) primary cesarean (PPH=18.7% of 2696)—macrosomia and multiparity; and (3) repeat cesarean (PPH=16.0% of 1832)—uterine incision other than low transverse and failed vaginal birth after cesarean.
Conclusion:
Clinical profiles that identify women at risk for PPH can provide a foundation for the development of primary prevention strategies.</description><subject>Algorithms</subject><subject>Cesarean section</subject><subject>Cesarean Section, Repeat - adverse effects</subject><subject>Childbirth & labor</subject><subject>Diabetes mellitus</subject><subject>Female</subject><subject>Fetal Macrosomia</subject><subject>Gynecology</subject><subject>Health aspects</subject><subject>Hemorrhage</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hysterectomy</subject><subject>Maternal mortality</subject><subject>Medical Audit</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Obstetrics</subject><subject>Odds Ratio</subject><subject>original-article</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Physiology</subject><subject>Placenta</subject><subject>Postpartum</subject><subject>Postpartum Hemorrhage - etiology</subject><subject>Postpartum Hemorrhage - prevention & control</subject><subject>Pregnancy</subject><subject>Pregnancy, Complications of</subject><subject>Prevention</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Risk groups</subject><subject>Uterus</subject><subject>Vagina</subject><subject>Women</subject><subject>Womens health</subject><issn>0743-8346</issn><issn>1476-5543</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kl2L1DAUhoMo7rh64R-QoLCg0DHfaS6XxY-Fhb3RSwmZ9rTTsW1qkirz722YgXF3Xc5FIOd53_PBQeg1JWtKePlxN60ZIWbNnqAVFVoVUgr-FK2IFrwouVBn6EWMO0JyUj9HZ9RQralQK_TjuoYxdc2-G1v8xw8w4sHHhPvuJ_R7nDzewAhNl3AT_ICnAL8z70ccU3AJ2g4ibnzA06KaXEjzgLcw-BC2roWX6Fnj-givju85-v7507err8XN7Zfrq8ubohKapqLSNaukqwWra-UYIw0pNTeSV1QSyhzTjSxdZTa1YY46wbkqlTJUguF1SQg_RxcH3yn4XzPEZIcuVtD3bgQ_R6s0M5IZtoDv7oE7P4dx6c0yJYjUnEq1UG8fpRgROfjJqnU92G5s_LKQKte1l4xQrklpcmfr_1BL1DB0lc-rXf7vCC7-EWzB9WkbfT_nnce74PsDWAUfY4DGTqEbXNhbSmw-C7ubbD4Lm8d-cxxo3gxQn8jjHSzAhwMQl9TYQjhN_NDtL-QBvU8</recordid><startdate>20090601</startdate><enddate>20090601</enddate><creator>Lu, M C</creator><creator>Korst, L M</creator><creator>Fridman, M</creator><creator>Muthengi, E</creator><creator>Gregory, K D</creator><general>Nature Publishing Group US</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7RV</scope><scope>7T5</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20090601</creationdate><title>Identifying women most likely to benefit from prevention strategies for postpartum hemorrhage</title><author>Lu, M C ; Korst, L M ; Fridman, M ; Muthengi, E ; Gregory, K D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c471t-c7d2c5ad42dd6a220f0873953c15012a27f58ac9bd92a1a4336866915e93d8003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Algorithms</topic><topic>Cesarean section</topic><topic>Cesarean Section, Repeat - adverse effects</topic><topic>Childbirth & labor</topic><topic>Diabetes mellitus</topic><topic>Female</topic><topic>Fetal Macrosomia</topic><topic>Gynecology</topic><topic>Health aspects</topic><topic>Hemorrhage</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hysterectomy</topic><topic>Maternal mortality</topic><topic>Medical Audit</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Obstetrics</topic><topic>Odds Ratio</topic><topic>original-article</topic><topic>Pediatric Surgery</topic><topic>Pediatrics</topic><topic>Physiology</topic><topic>Placenta</topic><topic>Postpartum</topic><topic>Postpartum Hemorrhage - etiology</topic><topic>Postpartum Hemorrhage - prevention & control</topic><topic>Pregnancy</topic><topic>Pregnancy, Complications of</topic><topic>Prevention</topic><topic>Retrospective Studies</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Risk groups</topic><topic>Uterus</topic><topic>Vagina</topic><topic>Women</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lu, M C</creatorcontrib><creatorcontrib>Korst, L M</creatorcontrib><creatorcontrib>Fridman, M</creatorcontrib><creatorcontrib>Muthengi, E</creatorcontrib><creatorcontrib>Gregory, K D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of perinatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lu, M C</au><au>Korst, L M</au><au>Fridman, M</au><au>Muthengi, E</au><au>Gregory, K D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Identifying women most likely to benefit from prevention strategies for postpartum hemorrhage</atitle><jtitle>Journal of perinatology</jtitle><stitle>J Perinatol</stitle><addtitle>J Perinatol</addtitle><date>2009-06-01</date><risdate>2009</risdate><volume>29</volume><issue>6</issue><spage>422</spage><epage>427</epage><pages>422-427</pages><issn>0743-8346</issn><eissn>1476-5543</eissn><abstract>Objective:
To identify women who are most likely to benefit from primary prevention strategies for postpartum hemorrhage (PPH).
Study Design:
In a retrospective patient cohort, we applied recursive partitioning algorithms to identify the most discriminant risk factors and their interactions, and calculated the ‘number needed to treat’ to prevent a single case of PPH (estimated blood loss >1000 ml).
Result:
By delivery category, the highest risk groups with ‘number needed to treat’ ranging from 4 to 7 were: (1) vaginal delivery (PPH=0.7% of 16 218)—macrosomia with gestational diabetes and manual removal of the placenta; (2) primary cesarean (PPH=18.7% of 2696)—macrosomia and multiparity; and (3) repeat cesarean (PPH=16.0% of 1832)—uterine incision other than low transverse and failed vaginal birth after cesarean.
Conclusion:
Clinical profiles that identify women at risk for PPH can provide a foundation for the development of primary prevention strategies.</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><pmid>19177146</pmid><doi>10.1038/jp.2009.2</doi><tpages>6</tpages></addata></record> |
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| source | MEDLINE; SpringerLink Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Algorithms Cesarean section Cesarean Section, Repeat - adverse effects Childbirth & labor Diabetes mellitus Female Fetal Macrosomia Gynecology Health aspects Hemorrhage Hospitals Humans Hysterectomy Maternal mortality Medical Audit Medicine Medicine & Public Health Obstetrics Odds Ratio original-article Pediatric Surgery Pediatrics Physiology Placenta Postpartum Postpartum Hemorrhage - etiology Postpartum Hemorrhage - prevention & control Pregnancy Pregnancy, Complications of Prevention Retrospective Studies Risk analysis Risk Factors Risk groups Uterus Vagina Women Womens health |
| title | Identifying women most likely to benefit from prevention strategies for postpartum hemorrhage |
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