Postpartum hemorrhage risk assessment—revisiting the three-tiered classification of low- medium- and high-risk

Risk of Postpartum Hemorrhage in Hypertensive Disorders of Pregnancy: Stratified by Severity

“…We conducted a preplanned secondary analysis of all individuals who delivered at our level IV center during two consecutive years (from March 2020 to March 2022). In the parent report, 25 individuals were included if they had a singleton gestation with 14 weeks and were admitted for delivery. Individuals were excluded if they were transferred postpartum or if they had a multiple gestation pregnancy.…”

“…Risk factors for PPH were collected according to those defined by ACOG, modified from the CMQCC Risk Assessment Tool, version 2, 26 and as previously described in our previous publications. 25,[27][28][29] PPH risk was stratified into low, medium, or high based on the ACOG risk stratification tool by researchers using variables known at the time of delivery. 14 In this secondary analysis, the primary exposure was any HDP which included cHTN, gHTN, and preeclampsia without and with severe features.…”

“…[48][49][50][51][52] However, we were able to report data for the individual components and we have previously published using the same composite. 25,[27][28][29] Although we have one of the largest study populations, we may not be able to detect minor differences in the uncommon outcomes (e.g., transfusion, surgical intervention) and this may contribute to a type II error. Finally, the management of cohorts was at a level IV center and the findings may not be applicable to community hospitals, where most of the deliveries in the United States occur.…”