Nomogram of ultrasound scoring system combined with clinical features for predicting postpartum hemorrhage in patients with pernicious placenta previa
Objective To observe the value of the nomogram constructed based on ultrasound scoring system combined with clinical features for predicting postpartum hemorrhage(PPH)in patients with pernicious placenta previa(PPP).Methods Data of 342 PPP pregnant women underwent cesarean section were retrospectively analyzed,including 243 underwent prenatal ultrasound scoring system evaluation(observation group)and 99 underwent routine ultrasound(control group).The maternal baseline data,maternal and infant outcomes were compared between groups.The amount of blood loss within 24 h postpartum of the observation group were recorded,and PPH was diagnosed when blood loss≥1 000 ml.Patients in observation group were divided into training set(n=194,including 107 PPH and 87 non-PPH)and test set(n=49,including 29 PPH and 20 non-PPH)at the ratio of 8:2.Then the clinical data and ultrasound scores of training set were analyzed using univariate and multivariate logistic regression,the independent risk factors for PPH in PPP patients were screened and a nomogram was constructed.The predictive efficacy,fit degree and clinical effectiveness of the nomogram were assessed.Results Significant differences of the amount of blood loss within 24 h after delivery,the amount of red blood cell suspension transfused,the time of operation,the time of hospital stay and the gestational week of delivery were detected between groups(all P＜0.05).The prenatal body mass index≥28 kg/m2,the number of labor induction/abortion≥3 and the score of ultrasound scoring system≥ 10 were all independent risk factors for PPH in PPP patients(all P＜0.05),then the nomogram was constructed,which had good fit.The area under the curve of the nomogram model for predicting PPH in patients with PPP in test set was 0.81.When the threshold was 0.22-0.98,the clinical net benefit was greater than 0.Conclusion Ultrasound scoring system combined with clinical features nomogram could be used to effectively predict PPH in PPP patient.
万方数据
维普
