Evidence map›Paper›PMID 38449994›Full record

ArticleCureus2024

Clinical Prediction of Retained Products of Conception: Combining Obstetric History and Ultrasound for Improved Accuracy in Severe Postpartum Hemorrhage.

Mariko Kurakazu, Masamitsu Kurakazu, Chihiro Kiyoshima, Koichiro Shigekawa, Toyofumi Hirakawa, Kenichi Yoshikawa, Tomohiro Ito, Daichi Urushiyama, Kohei Miyata, Fusanori Yotsumoto

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In one paragraph

Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.1field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Mariko KurakazuDepartment of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, JPN.
Masamitsu KurakazuDepartment of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, JPN.
Chihiro KiyoshimaDepartment of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, JPN.
Koichiro ShigekawaDepartment of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, JPN.
Toyofumi HirakawaDepartment of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, JPN.
Kenichi YoshikawaDepartment of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, JPN.
Tomohiro ItoDepartment of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, JPN.
Daichi UrushiyamaDepartment of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, JPN.
Kohei MiyataDepartment of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, JPN.
Fusanori YotsumotoDepartment of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, JPN.
Fukuoka University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background The current challenge is how to improve the management of postpartum hemorrhage (PPH) to reduce the maternal mortality rate further. This study aimed to investigate whether a combined specific obstetric history and ultrasonographic findings can improve the predictive accuracy of retained products of conception (RPOC) with severe PPH. Methods This retrospective study included 56 patients who were diagnosed with RPOC. We extracted the following clinical data: obstetric history of second-trimester miscarriage, the time at which there was clinical suspicion of RPOC after the previous pregnancy (TIME), grayscale ultrasonographic finding (RPOC long-axis length [SIZE]), and color Doppler ultrasonographic finding based on the Gutenberg classification (RPOC hypervascularity). In this study, we defined cases requiring blood transfusion therapy or transcatheter arterial embolization as severe PPH. The patients were divided into two groups according to the presence or absence of severe PPH. The predictors of severe PPH were evaluated using logistic regression models. Model A comprised a combination of second-trimester miscarriage and TIME, Model B comprised a combination of Model A and long-axis SIZE, and Model C comprised a combination of Model B and RPOC hypervascularity. Results The multivariable analysis showed that long-axis SIZE was the only significant predictor of severe PPH (odds ratio [OR], 10.38; 95% confidence interval [CI], 2.06-63.86) independent of second-trimester miscarriage, TIME, and RPOC hypervascularity. The c-statistic was higher in Model C (OR, 0.863; 95% CI, 0.731-0.936) than in Model A (OR, 0.723; 95% CI, 0.551-0.847) and Model B (OR, 0.834; 95% CI, 0.677-0.923). Conclusion Combining a specific obstetric history (second-trimester miscarriage and TIME) and ultrasonographic findings (long-axis SIZE and RPOC hypervascularity) improves the predictive accuracy of RPOC with severe PPH. This prediction model may be a useful clinical screening tool for RPOC with severe PPH.

Indexed as

blood transfusionhemorrhagemultivariate analysisodds ratioplacentapostpartum periodrisk managementultrasonography

Identifiers

PMID38449994
PMCPMC10917468
OpenAlexW4391527145

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.