Predictive risk scale of primary postpartum hemorrhage in Algerian women

Abstract

Introduction: The Primary postpartum hemorrhage is a multifactorial obstetric emergency; it represents one of the leading causes of preventable maternal morbidity and mortality worldwide.Objective: Elaborate and validate a predictive scale for the risk of primary postpartum hemorrhage in women with normal vaginal delivery.Methods: An analytical, cross-sectional, case-control study was carried out in 84 postpartum women belonging to the Charef Wilaya Djelfa Polyclinic,from Algeria, from January to December 2024. 21 mothers diagnosed with postpartum hemorrhage (cases) and 63 without this condition (controls) were included. The percentage was used as a summary measure of the qualitative variables, and the cross-product ratio, the confidence interval, and the chi-square test were determined. For the construction of the predictive model, a multivariate analysis was performed using binary logistic regression, from which the proposed scale was derived. The area under the curve and the Hosmer-Lemeshow goodness-of-fit test were obtained for its validation.Results: As the scale score increased, so did the percentage of patients with postpartum hemorrhage. The area under the curve was 0.812 (p = 0.000), and in the goodness of fit test a p-value of 0.567 was obtained.Conclusions: The proposed scale proves to be useful for predicting the risk of primary postpartum hemorrhage in women with normal vaginal delivery, showing very good discrimination and calibration capacity.