Huang et al reported the MONITOR model for predicting postpartum hemorrhage in a woman with immune thrombocytopenia purpura (ITP). The authors are from multiple institutions in China.
Patient selection: postpartum state for a woman with ITP
MONITOR is an acronym based on single letters from: maternal complication, WHO bleeding score, antepartum plateelt transfusion, placental abnormalities, platelet count, previous uterine surgery, primiparity.
(2) previous uterine surgery
(3) placental abnormalities (placenta previa; placenta accreta/increta/percreta; abruption)
(4) maternal complication (gestational hypertension; gestational diabetes)
(5) antepartum platelet transfusion
(6) platelet count in 10^9/L
(7) WHO bleeding score
previous uterine surgery
-0.010 * (count)
0 if > 100; 1 if 20 to 100; 3 if < 20
WHO bleeding score
value of X =
= SUM(points for all of the beta-coefficients) - 4.479
probability of hemorrhage =
= 1 / (1 + EXP((-1) * X))
total score =
= SUM(points for all of the parameters)
• mininum score: 0
• maximum score: 18.5
• The area under the ROC curve was 0.87 in internal validation cohort.
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