Ahmadzia et al reported models for predicting the risk of peripartum blood transfusion for a woman having a cesarean delivery. One model is for intrapartum evaluation. The authors are from George Washington University and Duke University.
Patient selection: woman having a cesarean delivery
Parameters:
(1) age in years
(2) body mass index (BMI)
(3) platelet count in 10^9/L
(4) hematocrit in percent
(5) gestational hypertension or pre-eclampsia
(6) eclampsia or HELLP
(7) abruption
(8) abruption was an indication of cesarean delivery
(9) number of previous cesarean deliveries
(10) insurance
(11) number of previous term deliveries
(12) heart disease
(13) general anesthesia
(14) failure to progress (FTP)
(15) accreta, increta or percreta
(16) intra-partum antibiotic therapy
(17) nonelective repeat cesarean delivery
(18) multiple birth
|
Parameter |
Finding |
Points |
|
age |
< 21 years |
0.1583 |
|
|
21 to 36 years |
0 |
|
|
> 36 years |
0.1583 |
|
body mass index |
|
-0.0153 * (BMI) |
|
platelet count |
< 150 * 10^9/L |
0.3706 |
|
|
>= 150 * 10^9/L |
0 |
|
hematocrit |
< 32 percent |
1.3111 |
|
|
>= 32 percent |
0 |
|
blood pressure disorder |
none |
0 |
|
|
pre-eclampsia |
0.3479 |
|
|
gestational hypertension |
0.3479 |
|
eclampsia or HELLP |
no |
0 |
|
|
yes |
1.0587 |
|
abruption |
no |
0 |
|
|
yes |
0.8218 |
|
abruption reason for CD |
no |
0 |
|
|
yes |
0.3313 |
|
previous cesarean deliveries |
0 |
0.5894 |
|
|
1 |
0 |
|
|
2 |
0.4069 |
|
|
>= 3 |
0 |
|
insurance |
none |
0.2258 |
|
|
Medicaid or Medicare |
0.2773 |
|
|
other |
0 |
|
number of previous term deliveries |
< 3 |
0 |
|
|
>= 3 |
0.6304 |
|
heart disease |
no |
0 |
|
|
yes |
0.7524 |
|
general anesthesia |
no |
0 |
|
|
yes |
1.6439 |
|
failture to progress |
no |
0 |
|
|
yes |
0.5205 |
|
accreta, increta or percreta |
no |
0 |
|
|
yes |
4.5154 |
|
intra-partum antibiotic therapy |
no |
0 |
|
|
yes |
0.2802 |
|
nonelective repeat CD |
no |
0 |
|
|
yes |
0.5607 |
|
multiple birth |
no |
0 |
|
|
yes |
0.5518 |
X =
= SUM(points for all 18 parameters) - 5.2402
probability of transfusion =
= 1 / (1 + EXP((-1) * X))
Specialty: Clinical Laboratory, Obstetrics & Gynecology
