Ultrasound-based nomogram for postpartum hemorrhage prediction in pernicious placenta previa
Background: Pernicious placenta previa (PPP) is one of the most dangerous complications in pregnancy after cesarean section, with high perinatal mortality. This study aimed to develop a nomogram to predict postpartum hemorrhage in patients with PPP.Methods: A total of 246 patients with confirmed PPP...
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| Format: | Article |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2022.982080/full |
| _version_ | 1818000137284222976 |
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| author | Yangzi Zhou Zixuan Song Xiaoxue Wang Mingjie Zhang Xueting Chen Dandan Zhang |
| author_facet | Yangzi Zhou Zixuan Song Xiaoxue Wang Mingjie Zhang Xueting Chen Dandan Zhang |
| author_sort | Yangzi Zhou |
| collection | DOAJ |
| description | Background: Pernicious placenta previa (PPP) is one of the most dangerous complications in pregnancy after cesarean section, with high perinatal mortality. This study aimed to develop a nomogram to predict postpartum hemorrhage in patients with PPP.Methods: A total of 246 patients with confirmed PPP at Shengjing Hospital of China Medical University from January 2018 to December 2021 were included. Patients were divided into to two cohorts depending on a postpartum blood loss of > 1000 ml (n = 146) or ≤ 1000 ml (n = 100). Lasso regression analysis was performed on the risk factors screened by univariate analysis to screen out the final risk factors affecting postpartum hemorrhage. Based on the final risk factors, a Nomogram prediction model with excellent performance was constructed using Logistic regression. A nomogram was constructed with further screening of the selected risk factors of postpartum hemorrhage in PPP. A second nomogram based only on the total ultrasonic risk score was constructed. Decision curve analysis (DCA) was used to evaluate the clinical efficacy of the nomograms.Results: Older age, larger gestational age, larger neonatal birth weight, presence of gestational diabetes mellitus, larger amniotic fluid index, absence of gestational bleeding, and higher ultrasonic risk single score were selected to establish a nomogram for postpartum hemorrhage in PPP. The area under the curve of the nomogram constructed by Lasso regression analysis was higher than that of the ultrasonic total score alone (0.887 vs. 0.833). Additionally, DCA indicated better clinical efficacy in the former nomogram than in the later nomogram. Furthermore, internal verification of the nomogram constructed by Lasso regression analysis showed good agreement between predicted and actual values.Conclusion: A nomogram for postpartum hemorrhage in PPP was developed and validated to assist clinicians in evaluating postpartum hemorrhage. This nomogram was more accurate than using the ultrasonic score alone. |
| first_indexed | 2024-04-14T03:18:00Z |
| format | Article |
| id | doaj.art-600d84a6664242dca9c03fead0723dbb |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-04-14T03:18:00Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj.art-600d84a6664242dca9c03fead0723dbb2022-12-22T02:15:23ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2022-08-011310.3389/fphys.2022.982080982080Ultrasound-based nomogram for postpartum hemorrhage prediction in pernicious placenta previaYangzi Zhou0Zixuan Song1Xiaoxue Wang2Mingjie Zhang3Xueting Chen4Dandan Zhang5Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Health Management, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Surgery, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Health Management, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, ChinaBackground: Pernicious placenta previa (PPP) is one of the most dangerous complications in pregnancy after cesarean section, with high perinatal mortality. This study aimed to develop a nomogram to predict postpartum hemorrhage in patients with PPP.Methods: A total of 246 patients with confirmed PPP at Shengjing Hospital of China Medical University from January 2018 to December 2021 were included. Patients were divided into to two cohorts depending on a postpartum blood loss of > 1000 ml (n = 146) or ≤ 1000 ml (n = 100). Lasso regression analysis was performed on the risk factors screened by univariate analysis to screen out the final risk factors affecting postpartum hemorrhage. Based on the final risk factors, a Nomogram prediction model with excellent performance was constructed using Logistic regression. A nomogram was constructed with further screening of the selected risk factors of postpartum hemorrhage in PPP. A second nomogram based only on the total ultrasonic risk score was constructed. Decision curve analysis (DCA) was used to evaluate the clinical efficacy of the nomograms.Results: Older age, larger gestational age, larger neonatal birth weight, presence of gestational diabetes mellitus, larger amniotic fluid index, absence of gestational bleeding, and higher ultrasonic risk single score were selected to establish a nomogram for postpartum hemorrhage in PPP. The area under the curve of the nomogram constructed by Lasso regression analysis was higher than that of the ultrasonic total score alone (0.887 vs. 0.833). Additionally, DCA indicated better clinical efficacy in the former nomogram than in the later nomogram. Furthermore, internal verification of the nomogram constructed by Lasso regression analysis showed good agreement between predicted and actual values.Conclusion: A nomogram for postpartum hemorrhage in PPP was developed and validated to assist clinicians in evaluating postpartum hemorrhage. This nomogram was more accurate than using the ultrasonic score alone.https://www.frontiersin.org/articles/10.3389/fphys.2022.982080/fullpernicious placenta previapostpartum hemorrhagenomogramunivariate logistic regressionLASSO regressiondecision curve analysis |
| spellingShingle | Yangzi Zhou Zixuan Song Xiaoxue Wang Mingjie Zhang Xueting Chen Dandan Zhang Ultrasound-based nomogram for postpartum hemorrhage prediction in pernicious placenta previa Frontiers in Physiology pernicious placenta previa postpartum hemorrhage nomogram univariate logistic regression LASSO regression decision curve analysis |
| title | Ultrasound-based nomogram for postpartum hemorrhage prediction in pernicious placenta previa |
| title_full | Ultrasound-based nomogram for postpartum hemorrhage prediction in pernicious placenta previa |
| title_fullStr | Ultrasound-based nomogram for postpartum hemorrhage prediction in pernicious placenta previa |
| title_full_unstemmed | Ultrasound-based nomogram for postpartum hemorrhage prediction in pernicious placenta previa |
| title_short | Ultrasound-based nomogram for postpartum hemorrhage prediction in pernicious placenta previa |
| title_sort | ultrasound based nomogram for postpartum hemorrhage prediction in pernicious placenta previa |
| topic | pernicious placenta previa postpartum hemorrhage nomogram univariate logistic regression LASSO regression decision curve analysis |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2022.982080/full |
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