Sensitivity, Specificity, and Predictive Values of Bigguzi’s risk Nomogram for Prediction of Postpartum Hemorrhage following Vaginal Delivery

Background: Postpartum hemorrhage is considered as one of the major causes of maternal mortality across the World. Thus, evaluation of underlying risk factors in this domain is assumed as one of the important strategies for prevention of postpartum hemorrhage. Considering that the most effective risk factors have been suggested in various studies on risk nomogram for prediction of postpartum hemorrhage, this study was conducted to determine sensitivity, specificity, and predictive value of this nomogram in prediction of postpartum hemorrhage. Methodology: The present research with a validity study design using diagnostic methods was performed prospectively on 600 women admitted to Omolbanin Hospital in the city of Mashhad (Iran) from May to October 2017. To this end; individual characteristics information, midwiferyand labor stages form and Bigguzi’s risk nomogram were used for data collection. The researcher measured and recorded lost blood volume in mothers via plastic blood collection bags and pads within 4 hours after delivery. Subsequently, Bigguzi’s risk nomogram was completed for each study sample and then probability score for postpartum hemorrhage was calculated by researcher’s assistants. The data obtained from study samples were entered into SPSS Statistics (Version 25) software and analyzed. Ultimately, receiver operating characteristic (ROC) curve of risk nomogram was plotted.Results: Postpartum hemorrhage occurred in 33.3% (n=200) of deliveries in this study. The area under the receiver operating characteristic (ROC) curve was calculated by 81.2%. The point of 0.1 with 85.5% sensitivity and 51.5% specificity was also selected as the proposed cut-off point. Moreover, positive and negative predictive values were reported by 63.8% and 78.0%; respectively .Conclusion: According to the results of this study, the risk nomogram was considered as an appropriate method for prediction of postpartum hemorrhage. Therefore, it was recommended as a simple and low-cost approach for prediction of postpartum hemorrhage in childbirth

Keywords:

Specificity and Sensitivity , Postpartum Hemorrhage , Risk Factor , Nomogram