title: Prediction of postpartum blood transfusion--risk factors and recurrence.
abstract: OBJECTIVE
  The aim was to find clinically useful risk factors for postpartum transfusion and to assess the joint predictive value in a population of women with a first and second delivery.
  
  
  METHODS
  All Danish women with a first and second delivery from January 2001 to September 2009 who gave birth in a hospital that reported transfusion of red blood cells to a national database: A total of 96 545 women were included.
  
  
  RESULTS
  Retained placental tissue explained more than all other risk factors in vaginal deliveries. Retained placental tissue at first delivery was associated with postpartum transfusion at a second vaginal delivery, and may also be used as an early predictor in parallel with a history of either placental abruption, postpartum transfusion or caesarean delivery. The positive predictive values of having more than one risk factor was low (2.2%-2.7%).
  
  
  CONCLUSIONS
  Prediction of postpartum transfusion is difficult. Retained placental tissue is the strongest predictor of postpartum blood transfusion in vaginal deliveries. Retained placental tissue is usually diagnosed for the first time when the bleeding starts, which limits the clinical value of prediction. We need tools for an early diagnosis of retained placenta to intervene early before transfusion is needed.
authors: Department of Anaesthesia and Intensive Care Medicine, University of Copenhagen, Herlev Hospital , Herlev , Denmark .
authors: Anne J
authors: AJ
authors: Wikkelsø
authors: Sofie
authors: S
authors: Hjortøe
authors: Thomas A
authors: TA
authors: Gerds
authors: Ann M
authors: AM
authors: Møller
authors: Jens
authors: J
authors: Langhoff-Roos
mesh_terms: D001803:Blood Transfusion / Q000706:statistics & numerical data*; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005544:Forecasting; D006801:Humans; D010298:Parity; D018457:Placenta, Retained / Q000453:epidemiology; D006473:Postpartum Hemorrhage / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D011247:Pregnancy; D012042:Registries; D012307:Risk Factors
keywords: Blood transfusion; postpartum haemorrhage; prediction; recurrence; retained placenta