D-Dimer: Predictor of Postpartum Hemorrhage among Pre-Eclampsia at Kilimanjaro Christian Medical Centre  

作　　者：Husna Silim Ally Nyasatu G. Chamba Raziya Gaffur Nasra Batchu Glory Mangi Pendo S. Mlay Bariki Mchome Mtoro J. Mtoro Thomas J. Kakumbi Rafiki N. Mjema Doris Rwenyagila Eusebius Maro Fredrick Mbise Gilleard Masenga Patricia S. Swai Husna Silim Ally;Nyasatu G. Chamba;Raziya Gaffur;Nasra Batchu;Glory Mangi;Pendo S. Mlay;Bariki Mchome;Mtoro J. Mtoro;Thomas J. Kakumbi;Rafiki N. Mjema;Doris Rwenyagila;Eusebius Maro;Fredrick Mbise;Gilleard Masenga;Patricia S. Swai(Department of Obstetrics and Gynaecology, KCMC Hospital, Moshi, Tanzania;Department of Obstetrics and Gynaecology, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania)

机构地区：[1]Department of Obstetrics and Gynaecology, KCMC Hospital, Moshi, Tanzania [2]Department of Obstetrics and Gynaecology, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania

出　　处：《Open Journal of Obstetrics and Gynecology》2024年第6期923-937,共15页妇产科期刊（英文）

摘　　要：Background: Postpartum hemorrhage (PPH) is the major contributor to maternal mortality and morbidity worldwide as well as in Tanzania. Studies have shown Pre-eclampsia as a risk indicator for Postpartum hemorrhage and D-dimer tends to rise in women with pre-eclampsia. Few studies that have shown the association between D-dimer and PPH have been controversial and differ according to ethnicity and lifestyle. Hence there is no suitable reference interval for D-dimer in predicting Postpartum hemorrhage among women with pre-eclampsia. Broad Objective: This study aimed to assess the association, sensitivity, and specificity of D-dimer as a laboratory predictor of postpartum hemorrhage among women with pre-eclampsia at KCMC hospital. Methodology: This was a hospital-based analytical cross-sectional study conducted at KCMC Hospital in Northern Tanzania from September 2022 to March 2023. A total of 195 women with pre-eclampsia were included in this study. Plasma D-dimer levels were taken from women with pre-eclampsia pre-delivery. Haematocrit was compared before and after delivery, and a fall of 10% was considered as Postpartum hemorrhage together with clinical assessment of the patient. Participants were divided among those who had severe features and those who did not have severe features and were further categorized into those who had PPH and those who did not have PPH. Logistic regression was used to determine the association between D-dimer and PPH adjusting for other factors. The Receiver Operating Curve (ROC) was used to evaluate the predictive value. Results: Higher median D-dimer levels were seen among women who had PPH compared to those who had no PPH. D-dimer was seen to be associated with PPH, thus for every unit increase of µg/ml of D-dimer among women who had pre-eclampsia without severe features there was a 14% significant increase in the odds of having postpartum hemorrhage and a 45% significant increase of having postpartum hemorrhage among those who had pre-eclampsia with severe features. Furthermore, tBackground: Postpartum hemorrhage (PPH) is the major contributor to maternal mortality and morbidity worldwide as well as in Tanzania. Studies have shown Pre-eclampsia as a risk indicator for Postpartum hemorrhage and D-dimer tends to rise in women with pre-eclampsia. Few studies that have shown the association between D-dimer and PPH have been controversial and differ according to ethnicity and lifestyle. Hence there is no suitable reference interval for D-dimer in predicting Postpartum hemorrhage among women with pre-eclampsia. Broad Objective: This study aimed to assess the association, sensitivity, and specificity of D-dimer as a laboratory predictor of postpartum hemorrhage among women with pre-eclampsia at KCMC hospital. Methodology: This was a hospital-based analytical cross-sectional study conducted at KCMC Hospital in Northern Tanzania from September 2022 to March 2023. A total of 195 women with pre-eclampsia were included in this study. Plasma D-dimer levels were taken from women with pre-eclampsia pre-delivery. Haematocrit was compared before and after delivery, and a fall of 10% was considered as Postpartum hemorrhage together with clinical assessment of the patient. Participants were divided among those who had severe features and those who did not have severe features and were further categorized into those who had PPH and those who did not have PPH. Logistic regression was used to determine the association between D-dimer and PPH adjusting for other factors. The Receiver Operating Curve (ROC) was used to evaluate the predictive value. Results: Higher median D-dimer levels were seen among women who had PPH compared to those who had no PPH. D-dimer was seen to be associated with PPH, thus for every unit increase of µg/ml of D-dimer among women who had pre-eclampsia without severe features there was a 14% significant increase in the odds of having postpartum hemorrhage and a 45% significant increase of having postpartum hemorrhage among those who had pre-eclampsia with severe features. Furthermore, t

关 键 词：D-DIMER PREECLAMPSIA Postpartum Hemorrhage Tanzania 

分 类 号：R65[医药卫生—外科学]