10 August 2023: Clinical Research
Impact of Maternal Preoperative Hemoglobin Levels on Intraoperative Hemorrhage Risk in Placenta Accrete Spectrum Disorders: A Retrospective Cross-Sectional Study
Baolian Zhang 1AE , Hong Liu 1AEF , Wenli Wang 2BCD , Jia Wang 3BCD , Yuping Jiang 2CD , Wen Jia 2BCD , Haiyan Li 2C , He Zhu 2C , Xiaona Du 2EF , Xianghua Huang 2EFG*DOI: 10.12659/MSM.940443
Med Sci Monit 2023; 29:e940443
Table 1 The demographic clinical characteristics of participants in this study.
| Characteristics | Value/percentage overall (n=538) | <1500n=330 | >1500n=208 | P |
|---|---|---|---|---|
| Age (years) | 31.12±4.68 | 30.77±4.74 | 31.68±4.53 | 0.027 |
| 411 (76.39%) | 258 (78.18%) | 153 (73.56%) | ||
| ≥35 | 127 (23.61%) | 72 (21.82%) | 55 (26.44%) | |
| Occupation | 0.123 | |||
| No | 359 (66.73%) | 212 (64.24%) | 147 (70.67%) | |
| Yes | 179 (33.27%) | 118 (35.76%) | 61 (29.33%) | |
| Region | 0.007 | |||
| Rural | 342 (63.57%) | 195 (59.09%) | 147 (70.67%) | |
| Urban | 196 (36.43%) | 135 (40.91%) | 61 (29.33%) | |
| GA (weeks) | 35.95±2.47 | 36.39±2.53 | 35.24±2.18 | |
| BMI (kg/m) | 28.33 (3.70) | 28.27±3.74 | 28.43±3.66 | 0.637 |
| 93 (17.68%) | 57 (17.48%) | 36 (18.00%) | 0.880 | |
| ≥25 | 433 (82.32%) | 269 (82.52%) | 164 (82.00%) | |
| Weight changes (kg) | 13.13±5.06 | 13.23±4.78 | 12.98±5.51 | 0.372 |
| Gravidity | 3.00 (2.00–4.00) | 3.22±1.45 | 3.65±1.47 | 0.001 |
| ≤3 | 302 (56.13%) | 195 (59.09%) | 107 (51.44%) | |
| >3 | 236 (43.87%) | 135 (40.91%) | 101 (48.56%) | |
| Parity | 1.00 (1.00–1.00) | 0.97±0.67 | 1.33±0.68 | |
| 0 | 84 (15.61%) | 69 (20.91%) | 15 (7.21%) | |
| 1 | 329 (61.15%) | 211 (63.94%) | 118 (56.73%) | |
| ≥2 | 125 (23.23%) | 50 (15.15%) | 75 (36.06%) | |
| NCS | 1.00 (0.00–1.00) | |||
| 0 | 141 (26.21%) | 123 (37.27%) | 18 (8.65%) | |
| 1 | 299 (55.58%) | 176 (53.33%) | 123 (59.13%) | |
| ≥2 | 98 (18.22%) | 31 (9.39%) | 67 (32.21%) | |
| VD | ||||
| No | 458 (85.13%) | 264 (80.00%) | 194 (93.27%) | |
| Yes | 80 (14.87%) | 66 (20.00%) | 14 (6.73%) | |
| UA | 0.069 | |||
| No | 191 (35.50%) | 127 (38.48%) | 64 (30.77%) | |
| Yes | 347 (64.50%) | 203 (61.52%) | 144 (69.23%) | |
| ART | 0.038 | |||
| No | 499 (92.75%) | 300 (90.91%) | 199 (95.67%) | |
| Yes | 39 (7.25%) | 30 (9.09%) | 9 (4.33%) | |
| HDP | ||||
| No | 231 (42.94%) | 165 (50.00%) | 66 (31.73%) | |
| Yes | 307 (57.06%) | 165 (50.00%) | 142 (68.27%) | |
| Multiple pregnancy | 0.744 | |||
| No | 524 (97.40%) | 322 (97.58%) | 202 (97.12%) | |
| Yes | 14 (2.60%) | 8 (2.42%) | 6 (2.88%) | |
| Placental location | ||||
| Posterior | 108 (20.53%) | 97 (30.50%) | 11 (5.29%) | |
| Lateral or others | 56 (10.65%) | 41 (12.89%) | 15 (7.21%) | |
| Anterior | 116 (22.05%) | 75 (23.58%) | 41 (19.71%) | |
| Central | 246 (46.77%) | 105 (33.02%) | 141 (67.79%) | |
| PP | ||||
| No | 118 (20.08%) | 106 (32.12%) | 12 (5.77%) | |
| Yes | 420 (77.92%) | 224 (67.88%) | 196 (94.23%) | |
| TPP | ||||
| Without | 118 (21.93%) | 106 (32.12%) | 12 (5.77%) | |
| Low-lying | 23 (4.28%) | 17 (5.15%) | 6 (2.88%) | |
| Marginal | 44 (8.18%) | 35 (10.61%) | 9 (4.33%) | |
| Partial | 22 (4.09%) | 18 (5.45%) | 4 (1.92%) | |
| Central | 331 (61.52%) | 154 (46.67%) | 177 (85.10%) | |
| Grade of PAS | ||||
| Grade 1 | 264 (49.07%) | 238 (72.12%) | 26 (12.50%) | |
| Grade 2 | 162 (30.11%) | 74 (22.42%) | 88 (42.31%) | |
| Grade 3 | 112 (20.82%) | 18 (5.45%) | 94 (45.19%) | |
| Histology-proven | ||||
| No | 382 (72.08%) | 299 (91.61%) | 83 (41.09%) | |
| Yes | 148 (27.92%) | 29 (8.84%) | 119 (58.91%) | |
| Pre-Hb (g/dL) | 10.99±1.39 | 11.30±1.29 | 10.49±1.41 | |
| 263 (48.88%) | 127 (38.48%) | 136 (65.38%) | ||
| ≥11 | 275 (51.12%) | 203 (61.52%) | 72 (34.62%) | |
| Birth weight (g) | 2688.08±607.37 | 2758.76±602.89 | 2575.41±598.82 | |
| IBL (ml) | 1593.29±1459.61 | 767.52±302.44 | 2903.41±1603.01 | |
| BMI – body mass index; GA – gestational age at delivery; NCS – numbers of cesarean section; VD – vaginal delivery; UA – uterine anomalies (fibroid tumors or previous uterine surgery or surgery abortion); HDP – hemorrhage during pregnancy; ART – assisted reproduction technology; PP – placenta previa; TPP – type of placenta previa; IBL – intraoperative blood loss; grade of PAS – grade of placenta accreta spectrum disorders; OR – odds ratio; CI – confidence interval; BMI – body mass index; GA – gestational age at delivery; HDP – hemorrhage during pregnancy; ART – assisted reproduction technology; TPP – type of placenta previa. | ||||