Evidence map›Paper›PMID 38726359›Full record

ArticleCureus2024

Risk Assessment of Critical Obstetric Bleeding With Low-Molecular-Weight Heparin.

Miho Akaishi, Kunio Tarasawa, Hirotaka Hamada, Noriyuki Iwama, Hasumi Tomita, Tetsuya Akaishi, Kiyohide Fushimi, Kenji Fujimori, Nobuo Yaegashi, Masatoshi Saito

Abstract read
PubMed Full text at PMC Publisher
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
–field-weighted citation impact
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. 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.

Miho AkaishiDepartment of Obstetrics and Gynecology, Tohoku University, Sendai, JPN.
Kunio TarasawaDepartment of Health Administration and Policy, Tohoku University, Sendai, JPN.
Hirotaka HamadaDepartment of Obstetrics and Gynecology, Tohoku University, Sendai, JPN.
Noriyuki IwamaDepartment of Obstetrics and Gynecology, Tohoku University, Sendai, JPN.
Hasumi TomitaDepartment of Obstetrics and Gynecology, Tohoku University, Sendai, JPN.
Tetsuya AkaishiDepartment of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, JPN.
Kiyohide FushimiDepartment of Health Policy and Informatics, Tokyo Medical and Dental University, Tokyo, JPN.
Kenji FujimoriDepartment of Health Administration and Policy, Tohoku University, Sendai, JPN.
Nobuo YaegashiDepartment of Obstetrics and Gynecology, Tohoku University, Sendai, JPN.
Masatoshi SaitoDepartment of Obstetrics and Gynecology, Tohoku University, Sendai, JPN.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUse of unfractionated heparin (UFH) during the peripartum period is considered to be a higher risk of critical obstetric bleeding compared to low-molecular-weight heparin (LMWH). However, the evidence for the safety of using LMWH during the peripartum period is currently lacking.

methodsThis study retrospectively investigated a nationwide medical database to clarify the safety of using LMWH during childbirth. The Japanese Nationwide Diagnosis Procedure Combination database was retrospectively reviewed, and data from women with childbirth between 2018 and 2022 were collected.

resultsAmong the overall 354,299 women with childbirth, 3,099 were with obstetric disseminated intravascular coagulation (DIC), 484 were with critical obstetric bleeding requiring massive red blood cell (RBC) transfusion ≥4,000 cc, and 38 were with maternal death. Among the overall women, each of the anticoagulants other than LMWH was associated with critical obstetrical bleeding with an adjusted odds ratio (aOR) greater than 1.0, while LMWH was not associated with critical obstetrical bleeding (aOR, 0.54 (95% confidence interval, 0.11-2.71)). This finding did not change in subgroup analyses among those with Cesarean section. Furthermore, UFH was associated with critical bleeding among the 3,099 women with obstetrical DIC (aOR, 3.91 (2.83-5.46)), while LMWH was not (aOR, 0.26 (0.03-1.37)).

conclusionThe use of UFH was significantly associated with an increased critical obstetric hemorrhage requiring massive RBC transfusion or total hysterectomy. Meanwhile, the use of LMWH was not associated with increased critical obstetric bleeding. LMWH would be safer than UFH to be used for women during childbirth.

Indexed as

anticoagulantscritical obstetric bleedinglow molecular weight heparinobstetrical disseminated intravascular coagulation (dic)unfractionated heparin

Identifiers

PMID38726359
PMCPMC11079502

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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.