%0 Journal Article %T Predictors for Massive Haemorrhage during Caesarean Delivery Due to Placenta Praevia %A Mara Burgers %A Katrien Oude Rengerink %A Sanne J. Eschbach %A Moira M. Muller %A Marielle G. van Pampus %A Ben W. J. Mol %A Irene M. de Graaf %J International Journal of Clinical Medicine %P 96-104 %@ 2158-2882 %D 2015 %I Scientific Research Publishing %R 10.4236/ijcm.2015.62014 %X
Objectives: To describe the incidence and predictive factors for massive haemorrhage during a caesarean delivery in women with placenta praevia. Methods: We performed a retrospective cohort study among consecutive women with a placenta praevia planned for a caesarean delivery between 2001-2011 in one academic centre and two teaching hospitals in the Netherlands. Massive haemorrhage was defined as ¡Ý1000 mL blood loss during caesarean section. We used logistic regression analysis to assess which maternal and pregnancy characteristics were predictors for massive haemorrhage during caesarean delivery. Results: Of 54,794 deliveries, we identified 215 (0.39%) women with placenta praevia who underwent a Caesarean delivery, of whom 94 (44%) had massive haemorrhage at or after surgery. After univariable preselection, multivariable logistic regression indicated that higher maternal age (OR 2.09; 95% CI 1.17 - 3.74), no Caucasian ethnicity (OR 1.73; 95% CI 0.92 - 3.27), multiple pregnancy (OR 3.92; 95% CI 0.72 - 21.28), lower systolic blood pressure during pregnancy (OR 1.03; 95% CI 1.00 - 1.07) and the placenta located at the anterior wall (OR 2.21; 95% CI 1.20 - 4.04) were independent predictors for massive haemorrhage during a caesarean delivery in women with placenta praevia. Predicted probabilities varied between 22% and 71%. The model has a reasonable discriminative ability and acceptable calibration. Conclusions: Women with placenta praevia are at high risk for massive haemorrhage during caesarean delivery. The risk profile can be used to identify extreme high-risk women in whom extensive preventive measures are justified.
%K Placenta Praevia %K Massive Haemorrhage %K Caesarean Section %K Predictors %U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=54229