Maher et al reported a nomogram for predicting postpartum hemorrhage based on findings of the intrapartum period. The authors are from University College Cork and INFANT Research Centre in Cork, Ireland.
Parameters:
(1) mode of delivery
(2) history of postpartum hemorrhage (PPH)
(3) parity
(4) macrosomia
Parameter
Finding
Points
delivery
operative vaginal delivery
5.709
prelabor C-section
7.086
emergency C-section
8.231
spontaneous vaginal
0
history of PPH
no
0
yes
9.952
number of previous pregnancies
0
1.721
>= 1
0
macrosomia
no
0
yes
3.367
where:
• Although an emergency cesearean section can be performed before labor, it was considered one of 4 modes of delivery used in the study.
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 30.359
value of X =
= (0.2139 * (score)) - 4.448
probability of postpartum hemorrhage =
= 1 / (1 { EXP((-10 * X))
Performance:
• The area under the ROC curve is 0.75.
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