Analysis of factors influencing organ function injury in postpartum hemorrhage
10.3969/j.issn.1008-9691.2025.04.014
- VernacularTitle:产后出血发生器官功能损伤的影响因素分析
- Author:
Peijun ZHANG
1
;
Tingting HU
;
Jun SU
Author Information
1. 浙江大学医学院附属妇产科医院重症医学科,浙江 杭州 310006
- Publication Type:Journal Article
- Keywords:
Postpartum hemorrhage;
Sequential organ failure assessment;
Iliac artery balloon occlusion
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2025;32(4):467-470
- CountryChina
- Language:Chinese
-
Abstract:
Objective Exploring the influencing factors of organ dysfunction following postpartum hemorrhage.Methods A retrospective study was conducted on 140 patients with postpartum hemorrhage admitted to the department of critical care medicine at the Women's Hospital School of Medicine Zhejiang University between January 2020 and December 2023.Based on the sequential organ failure assessment(SOFA)score within 24 hours of ICU admission,patients were categorized into an observation group(SOFA≥2,54 cases)and a control group(SOFA<2,86 cases).Clinical data collected for both groups included age,prenatal body mass index(BMI),postpartum hemorrhage volume,obstetric and induced abortion history,use of assisted reproductive technology,and pre-delivery prophylactic iliac artery balloon,the differences in the above data between the two groups of patients to determine whether there was any organ damage were compared,and variables showing statistically significant differences were subsequently included in a multivariate Logistic regression analysis.Receiver operator characteristic curve(ROC curve)were plotted,and area under the curve(AUC)was calculated to evaluate the predictive performance of each influencing factor.Results The univariate analysis revealed no statistically significant differences in age,prenatal BMI,obstetric history,induced abortion history,or use of assisted reproductive technology between the two groups(all P>0.05).Compared with the control group,the observation group had significantly higher postpartum hemorrhage volume[mL:1850(1500,2500)vs.1500(1000,2 000),P<0.05]and a significantly lower proportion of patients with prophylactic iliac artery balloon[13.0%(7/54)vs.32.6%(28/86),P<0.05].Multivariate Logistic regression analysis of the two statistically significant factors from the univariate analysis showed that postpartum hemorrhage volume>1 000 mL was a risk factor for organ dysfunction[odds ratio(OR)=5.602,95%confidence interval(95%CI)was 1.569-20.002,P=0.008],while prophylactic placement of an iliac artery balloon was a protective factor against organ dysfunction(OR=0.377,95%CI was 0.147-0.971,P=0.043).ROC curve analysis demonstrated that postpartum hemorrhage volume had the highest predictive value for organ dysfunction,with an AUC=0.704 95%CI was 0.618-0.790,P<0.001.At the optimal cut-off value of 1 400 mL,the sensitivity was 48.8%and the specificity was 81.5%.The combination of a postpartum hemorrhage volume>1000 mL and pre-delivery prophylactic iliac artery balloon showed the next highest predictive value(AUC=0.666,95%CI was 0.577-0.755,P=0.001).Conclusions Postpartum hemorrhage volume>1 000 mL is a risk factor for organ dysfunction following postpartum hemorrhage and demonstrates certain predictive value,while the pre-delivery prophylactic iliac artery balloon can reduce the incidence of organ dysfunction and serves as a protective factor.
