Prediction Value of FAR,CD40L and MMP-9 Levels in Peripheral Blood of Patients with Penetrating and Dangerous Placenta Previa before Cesare-an Section for Postpartum Hemorrhage
Objective To investigate the predictive value of fibrinogen to albumin ratio(FAR),leukocyte differenti-ation antigen 40 ligand(CD40L)and matrix metalloproteinase-9(MMP-9)levels in postpartum hemorrhage in patients with penetrating and dangerous placenta previa(PPP)before cesarean section.Methods A total of 115 patients with penetrating PPP in maternal and child health hospital TangShan,from January 2017 to December 2023 were selected as the study objects,and were divided into bleeding group(n=62)and non-bleeding group(n=53)according to postpartum hemorrhage.Base-line data,FAR,CD40L and MMP-9 levels before cesarean section were compared between the two groups,and the influencing factors and relationships of postpartum hemorrhage in penetrating PPP patients were analyzed.The predictive value of FAR,CD40L and MMP-9 levels on postpartum hemorrhage was evaluated using ROC.Results There were significant differences in age,proportion of central placenta previa type and number of cesarean section between the two groups(P＜0.05).The levels of CD40L and MMP-9 in bleeding group were higher than those in non-bleeding group(P＜0.05).Age,central placenta pre-via,number of cesarean section,FAR,CD40L and MMP-9 levels were the influencing factors of postpartum hemorrhage in penetrating PPP patients(P＜0.05).The levels of FAR,CD40L and MMP-9 were still significantly correlated with postpar-tum hemorrhage in penetrating PPP patients(P＜0.05).The AUC predicted by FAR,CD40L and MMP-9 alone and in com-bination were 0.795,0.768,0.803 and 0.935,respectively,and the AUC predicted by FAR,CD40L and MMP-9 combined was higher than that predicted by FAR,CD40L and MMP-9 alone(P＜0.05).Conclusion FAR,CD40L and MMP-9 are associated with postpartum hemorrhage in penetrating PPP patients.Combined detection has high predictive value for postpar-tum hemorrhage in patients,and it is expected to become a marker for predicting postpartum hemorrhage in penetrating PPP patients.
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