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Identifying women most likely to benefit from prevention strategies for postpartum hemorrhage

Journal of Perinatology volume 29, pages 422–427 (2009)Cite this article

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.

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Acknowledgements

Financial support for this work was provided by the California Department of Health Services Maternal and Child Health Branch (Contract No. 01-15166).

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Authors and Affiliations

  1. Departments of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    M C Lu

  2. Department of Community Health Sciences, Los Angeles, CA, USA

    M C Lu & E Muthengi

  3. Center for Healthier Children, Families and Communities, UCLA School of Public Health, Los Angeles, CA, USA

    M C Lu & K D Gregory

  4. Department of Obstetrics and Gynecology, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA

    L M Korst & K D Gregory

  5. AMF Consulting, Inc, Los Angeles, CA, USA

    M Fridman

  6. Cedars-Sinai Medical Center and Burns Allen Research Institute, Los Angeles, CA, USA

    K D Gregory

Authors
  1. M C Lu
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  2. L M Korst
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  3. M Fridman
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  4. E Muthengi
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  5. K D Gregory
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Correspondence to L M Korst.

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Lu, M., Korst, L., Fridman, M. et al. Identifying women most likely to benefit from prevention strategies for postpartum hemorrhage. J Perinatol 29, 422–427 (2009). https://doi.org/10.1038/jp.2009.2

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