Factors that predict low hematocrit levels in the postpartum patient after vaginal delivery

Petersen, Linda A.; Lindner, Deborah S.; Kleiber, Charmaine; Zimmerman, M. Bridget; Hinton, Almira T.; Yankowitz, Jerome

doi:10.1067/mob.2002.121255

Cited by 39 publications

(29 citation statements)

References 8 publications

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“…Cesarean delivery is a well-recognized risk factor for severe PPH [13]. Among the women who had a vaginal delivery, a greater proportion of the cases underwent an operative vaginal delivery, another well-recognized risk factor for PPH [5,7,13]. We found that certain factors that may impair uterine contractility and affect systemic hemostasis were also risk factors for severe PPH.…”

Section: Discussionmentioning

confidence: 83%

“…This was independent of maternal age, parity, mode of delivery and birth weight. An increased risk of severe PPH has previously been reported among Hispanic women undergoing both vaginal [7,21] and cesarean delivery [6,9], even when controlling for larger infants, higher parity and longer labor. Hispanic women, particularly the Hispanic women of Central American origin in our study, are constitutionally different from other racial/ethnic groups.…”

Section: Discussionmentioning

confidence: 99%

“…Severe PPH is less common, but is a significant contributor to maternal morbidity and the deaths of an estimated 75,000–100,000 women worldwide each year [3,4]. Multiple studies have evaluated the underlying risk factors and causes for PPH [5,6,7,8,9]. Factors which have been associated with severe PPH include placental abruption, placenta previa, multiple gestation, retained placenta (including placenta accreta), cervical or vaginal lacerations, episiotomy, fetal macrosomia, maternal obesity, induction of labor, prolonged or rapid delivery, high parity, history of uterine atony in a prior pregnancy, chorioamnionitis, uterine inversion, and uterine rupture [10].…”

Section: Introductionmentioning

confidence: 99%

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Body Mass Index and Severe Postpartum Hemorrhage

Paglia

Grotegut

Johnson

et al. 2011

Gynecol Obstet Invest

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Background/Aims: The purpose of this study was to determine the relationship between maternal characteristics and severe postpartum hemorrhage (PPH). Methods: Medical records of women who delivered at Duke University Hospital between 2001 and 2004 with an ICD-9 code for PPH were reviewed. Women with PPH who received blood component therapy (severe PPH) were selected as cases and compared with controls matched for age, parity and mode of delivery. Results: Among 12,476 deliveries, there were 109 women with severe PPH. Hispanic women had an almost fourfold increase in the odds of severe PPH [OR 3.9 (1.8, 8.7)] that persisted when controlling for other significant predictors of PPH. Women with PPH were almost two times more likely [OR 1.8 (1.1, 3.1)] to have a BMI <30 when controlling for Hispanic ethnicity, oxytocin exposure, labor induction, treatment with magnesium and chorioamnionitis. Conclusion: Systemic factors as well as obstetrical factors modify the risk of severe PPH. Hispanic women and women with a BMI <30 are more likely to have severe PPH. When mode of delivery is controlled for, BMI ≧30 is associated with a reduced risk of severe PPH.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Body Mass Index and Severe Postpartum Hemorrhage

Paglia

Grotegut

Johnson

et al. 2011

Gynecol Obstet Invest

View full text Add to dashboard Cite

show abstract

“…Retenons que la transfusion sanguine reste le seul traitement d'urgence qui permet un apport immédiat et efficace de globules rouges et que seule une appréciation clinique pertinente associée à une numération globulaire systématique dans les 48 heures du post-partum permettra d'opter pour l'utilisation de fer intraveineux [9,10].…”

Section: Transfusionunclassified

Anémies sévères du post-partum immédiat. Pratique clinique et intérêt du fer par voie intraveineuse

Broche¹,

Armand-Branger

Grangeasse

et al. 2004

Gynécologie Obstétrique & Fertilité

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“…One looking at patients undergoing cardiopulmonary bypass surgery [5] identified various factors including older age, female sex, Hispanic or non-white ethnic origins, lower body surface area, and high creatinine as independent predictors of a hematocrit level of 21.9% or lower. Petersen et al [6] looked at predictors of postpartum hematocrit after vaginal delivery and found that an estimated blood loss of more than 500 mL, Hispanic ethnic origin, and third- or fourth-degree perineal laceration were objective predictors of a hematocrit level of less than 26% [6]. The aim of these previous studies was to be able to predict which patients would have hematocrit values at or below a certain threshold; however, few studies have provided a model capable of accurately predicting a postoperative blood count value.…”

Section: Introductionmentioning

confidence: 99%

Predicting postoperative day 1 hematocrit levels after uncomplicated hysterectomy

Swenson

Lanham

Morgan

et al. 2015

Intl J Gynecology & Obste

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Objective To develop a model for predicting postoperative hematocrit levels after uncomplicated hysterectomy. Methods In a retrospective study, data were analyzed from the Michigan Surgery Quality Collaborative for non-emergent hysterectomies performed for benign indications among women aged at least 18 years between January 1, 2012, and April 4, 2014. Linear mixed models were used for univariate and multivariate analyses. Results The model was developed with data from 4747 hysterectomies and validated on 1184 cases. In the mixed multivariate analysis, higher postoperative day 1 (POD1) hematocrit levels were associated with higher weight (B=0.03222, P<0.001), higher preoperative hematocrit (B=0.6587, P<0.001), and non-vaginal hysterectomy (B=0.2815, P=0.0055). Lower POD1 hematocrit was associated with higher preoperative platelet count (B=–0.00457, P<0.001), greater estimated blood loss (B=– 0.00652, P<0.001), and larger intraoperative crystalloid volume (B=–0.3303, P<0.001). The final model predicted POD1 hematocrit within 4% points of the actual value for 91.7% of cases in the validation set. Conclusion Use of the model after uncomplicated hysterectomy might help to support the practice of selectively conducting postoperative hematocrit tests after hysterectomy in a clinically thoughtful and cost-effective manner.

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Factors that predict low hematocrit levels in the postpartum patient after vaginal delivery

Cited by 39 publications

References 8 publications

Body Mass Index and Severe Postpartum Hemorrhage

Body Mass Index and Severe Postpartum Hemorrhage

Anémies sévères du post-partum immédiat. Pratique clinique et intérêt du fer par voie intraveineuse

Predicting postoperative day 1 hematocrit levels after uncomplicated hysterectomy

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