The Predictive Value of Red Blood Cell Distribution Width/Platelet Count Ratio for Postpartum Hemorrhage in Patients with a Second Pregnancy in a Scarred Uterus
ZHANG Xia
MOU Xia
GAO Peng
LIU Zhengfei
Abstract：Objective To explore the predictive value of red blood cell distribution width(RDW)/platelet count(PLT)ratio(RPR)for postpartum hemorrhage in patients with a second pregnancy in a scarred uterus.Methods A total of 122 patients with a second pregnancy in a scarred uterus who delivered at Yibin First People's Hospital from August 2021 to August 2024 were selected.Postpartum hemorrhage cases were included in the postpartum hemorrhage group(n=23),while non-hemorrhage cases were included in the postpartum non-hemorrhage group(n=99).Clinical data were collected for all subjects.RDW and PLT were measured using a blood cell analyzer,and RPR was calculated.Receiver operating characteristic(ROC)curves were used to analyze the predictive performance of RPR for postpartum hemorrhage,while multivariate Logistic regression was employed to identify influencing factors.Results The RDW and RPR levels were higher,while PLT was lower in the postpartum hemorrhage group compared to the non-hemorrhage group(P＜0.05).The area under the ROC curve(AUC,95％confidence interval[CI])for predicting postpartum hemorrhage was 0.803(0.758-0.853)for RDW,0.729(0.684-0.779)for PLT,and 0.901(0.851-0.946)for RPR.The proportions of uterine scar thickness≤3 mm,curettage≥2 times,uterine incision tear,and newborn birth weight≥4000 g were higher in the postpartum hemorrhage group(P＜0.05).Multivariate Logistic regression showed that uterine scar thickness≤3 mm(odds ratio[OR]=2.239,95％CI:1.350-3.712),newborn birth weight≥4 000 g(OR=2.502,95％CI:1.318-4.749),and RPR≥0.08(OR=3.773,95％CI:1.893-7.523)were significant influencing factors for postpartum hemorrhage(P＜0.05).Conclusion A high RPR value is closely associated with postpartum hemorrhage in patients with a second pregnancy in a scarred uterus and can serve as a biomarker for its prediction.
Keywords：Scar uterusPatients with a second pregnancyPostpartum hemorrhageRed blood Cell distribu-tion width/platelet count ratioROC curve
Publication Date：2024-11-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 1670-1674 )