Archives of Gynecology and Obstetrics

, Volume 291, Issue 2, pp 281–285 | Cite as

Calculating probability of requiring allogeneic blood transfusion using three preoperative risk factors on cesarean section for placenta previa

  • Yosuke Baba
  • Akihide Ohkuchi
  • Rie Usui
  • Hirotada Suzuki
  • Tomoyuki Kuwata
  • Shigeki Matsubara
Maternal-Fetal Medicine

Abstract

Purpose

To construct a model to calculating probability of requiring allogeneic blood transfusion on cesarean section (CS) for placenta previa (PP).

Methods

A retrospective cohort study involving all 205 patients with PP who underwent CS in our institute. We determined the relationship between allogeneic blood transfusion and nine preoperative factors: (1) maternal age, (2) parity, (3) uterine myoma, (4) previous CS, (5) the placenta covering the previous CS scar (referred to as “scar covering”), (6) degree of previa, (7) ultrasound finding of lacunae, (8) preoperative anemia, and (9) preparation of autologous blood. Independent risk factors of allogeneic blood transfusion were identified by multivariate logistic regression analysis. These significant factors were included in the final model, and, the probability of allogeneic blood transfusion was calculated.

Results

Independent risk factors of allogeneic blood transfusion were scar covering, previous CS without scar covering, and lacunae. These three factors were used to create a predictive model. The model revealed that patients with scar covering and lacunae had the highest probability (0.73), while those with no risk factors had the lowest probability (0.02).

Conclusion

This simple model may be useful to calculate probability of requiring allogeneic blood transfusion on CS for placenta previa.

Keywords

Blood transfusion Cesarean section Placenta accreta Placental lacunae Placenta previa 

Abbreviations

BT

Blood transfusion

CS

Cesarean section

FFP

Fresh frozen plasma

IQR

Interquartile range

OR

Odds ratio

PC

Platelet concentrate

PP

Placenta previa

RCC

Red cell concentrate

ROC

Receiver operating characteristic

Notes

Conflict of interest

The authors declare that we have no conflicts of interest regarding this article.

References

  1. 1.
    Patterson JA, Roberts CL, Bowen JR, Irving DO, Isbister JP, Morris JM, Ford JB (2014) Blood transfusion during pregnancy, birth, and the postnatal period. Obstet Gynecol 123(1):126–133PubMedCrossRefGoogle Scholar
  2. 2.
    Ohkuchi A, Onagawa T, Usui R, Koike T, Hiratsuka M, Izumi A, Ohkusa T, Matsubara S, Sato I, Suzuki M, Minakami H (2003) Effect of maternal age on blood loss during parturition: a retrospective multivariate analysis of 10,053 cases. J Perinat Med 31(3):209–215PubMedCrossRefGoogle Scholar
  3. 3.
    Hasegawa J, Matsuoka R, Ichizuka K, Mimura T, Sekizawa A, Farina A, Okai T (2009) Predisposing factors for massive hemorrhage during Cesarean section in patients with placenta previa. Ultrasound Obst Gynecol Off J Int Soc Ultrasound Obst Gynecol 34(1):80–84CrossRefGoogle Scholar
  4. 4.
    Yang JI, Lim YK, Kim HS, Chang KH, Lee JP, Ryu HS (2006) Sonographic findings of placental lacunae and the prediction of adherent placenta in women with placenta previa totalis and prior cesarean section. Ultrasound Obstet Gynecol Off J Int Soc Ultrasound Obst Gynecol 28(2):178–182CrossRefGoogle Scholar
  5. 5.
    Baba Y, Matsubara S, Ohkuchi A, Usui R, Kuwata T, Suzuki H, Takahashi H, Suzuki M (2014) Anterior placentation as a risk factor for massive hemorrhage during cesarean section in patients with placenta previa. J Obstet Gynaecol Res 40(5):1243–1248PubMedCrossRefGoogle Scholar
  6. 6.
    Japan Society of Obstetrics and Gynecology (2008) Placenta previa. In: Japan Society of Obstetrics and Gynecology (ed) Glossary of obstetrics and gynecology, 2nd edn. Kanehara Co. Ltd., Tokyo, p 226–227Google Scholar
  7. 7.
    Comstock CH, Love JJ Jr, Bronsteen RA, Lee W, Vettraino IM, Huang RR, Lorenz RP (2004) Sonographic detection of placenta accreta in the second and third trimesters of pregnancy. Am J Obstet Gynecol 190(4):1135–1140PubMedCrossRefGoogle Scholar
  8. 8.
    Finberg HJ, Williams JW (1992) Placenta accreta: prospective sonographic diagnosis in patients with placenta previa and prior cesarean section. J Ultrasound Med Off J Am Inst Ultrasound Med 11(7):333–343Google Scholar
  9. 9.
    Japaraj RP, Mimin TS, Mukudan K (2007) Antenatal diagnosis of placenta previa accreta in patients with previous cesarean scar. J Obstet Gynaecol Res 33(4):431–437PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Yosuke Baba
    • 1
  • Akihide Ohkuchi
    • 1
  • Rie Usui
    • 1
  • Hirotada Suzuki
    • 1
  • Tomoyuki Kuwata
    • 1
  • Shigeki Matsubara
    • 1
  1. 1.Department of Obstetrics and GynecologyJichi Medical UniversityShimotsukeJapan

Personalised recommendations