Development of a scoring system to predict massive postpartum transfusion in placenta previa totalis

• Published in: Journal of anesthesia 2017-08, Vol.31 (4), p.593-600
• Main Authors: Kim, Jung-Won, Lee, Yoon-Kyung, Chin, Ji-Hyun, Kim, Seon-Ok, Lee, Mi-Young, Won, Hye-Sung, Choi, Woo-Jong
• Format: Article
• Language: English
• Subjects: Adult; Anesthesiology; Blood Transfusion; Cesarean Section - adverse effects; Cohort Studies; Complications and side effects; Critical Care Medicine; Diagnosis; Emergency Medicine; Female; Gestational Age; Health aspects; Humans; Intensive; Magnetic resonance imaging; Medicine; Medicine & Public Health; Original Article; Pain Medicine; Placenta previa; Placenta Previa - physiopathology; Placental abruption; Postpartum Hemorrhage - therapy; Pregnancy; Prevention; Retrospective Studies; Risk Factors; ROC Curve; Ultrasonography - methods
• ISSN: 0913-8668; 1438-8359
• DOI: 10.1007/s00540-017-2365-8

Purpose It is important to predict massive postpartum hemorrhage in patients with placenta previa totalis (PPT) and a method that accurately predicts this event is needed. The present study developed a scoring system that predicts massive transfusion in patients with PPT. Methods This single-center retrospective cohort study comprised 238 patients with PPT who underwent caesarean section between January 2004 and December 2010. Massive transfusion was defined as the transfusion of ≥8 units of packed red blood cells within 24 h after delivery. Multivariate regression analysis was used to estimate the risks of massive transfusion. A probability score model was then constructed and tested for performance. Subsequently, the model was validated in other patients with PPT ( n  = 117). Results Thirty-one patients (13.0%) underwent massive transfusion. Ultrasound suspicion of placental adhesion, previous caesarean section, gestational age