Objectives: To determine the significance of the placental
thickness, the thickness of the uterine muscle layer at the
placental attachment site and the placental myometrial ratio in
the prediction of postpartum hemorrhage and to evaluate them
as parameters for identifying high-risk patients. Methods:
The present prospective observational cohort study involved
150 female patients with full-term pregnancy and single viable
fetus. All patients were subjected to postpartum blood loss
estimation and correlation between estimated blood loss
(EBL) with placental thickness and myometrial ratio were
done. Results: Placental thickness, placental-myometrial ratio
(PMR) and time of delivery were significantly higher in highEBL group compared to normal-EBL group. Myometrial
thickness was significantly lower in high EBL group than
normal EBL one. Multivariate analysis revealed that
predictive significance of postpartum blood loss, PMR were
the best independent predictors of postpartum blood loss
(P5.47 mm, 5.66mm respectively.
These cutoffs corresponded to sensitivities of 75%, 81.25%,
and 81.25%, and specificities of 67.16%, 93.28%, and 96.27%. Increased placental thickness and thinning of
myometrium are significant predictors of PPH. Conclusion:
This study indicates that lower myometrial thickness, larger
Placental thickness, increased PMR are significantly linked with prediction of PPH. |
