Association of Timing of Plasma Transfusion With Adverse Maternal Outcomes in Women With Persistent Postpartum Hemorrhage

Autor: Henriquez, D.D.C.A., Caram-Deelder, C., Cessie, S. le, Zwart, J.J., Roosmalen, J.J.M. van, Eikenboom, J.C.J., So-Osman, C., Watering, L.G. van de, Zwaginga, J.J., Koopman-van Gemert, A.W.M.M., Bloemenkamp, K.W.M., Bom, J.G. van der, Bank, C.M.C., Snuif-de Lange, Y.S., Gammeren, A.J. van, Papatsonis, D.N.M., Klinkspoor, H., Kok, M., Boer, B.A. de, Langenveld, J., Leers, M.P.G., Diris, J.H.C., Kok, R.D., Engbers, P., Hanssen, M.J.C.P., Wijngaarden, W.J. van, Schippers, D.H., Stappen, J.J. van der, Hasaart, T.H.M., Kerkhof, D.H. van de, Kok, J.B. de, Unnik, G.A. van, Kortlandt, W., Schuitemaker, N.E., Delemarre, F.M.C., Duijnhoven, H.L.P. van, Duvekot, H.J., Hogenboom, S., Kleiverda, G., Etten-van Hulst, M.J.W. van, Mirani-Oostdijk, K.P., Kampen, C. van, Weinans, M.J.N., Adriaanse, H.J., Huisjes, A.J.M., Frasa, M.A.M., Keuren, J.F.W., Meir, C.A. van, Feitsma, H., Hudig, F., Sikkema, J.M., Baas, M.I., Fouraux, M.A., Hmetz, G.C., Bijvank, B.H.N., Rondeel, H.J.M., Roelofsen, J.M.T., Doesburg-van Kleffens, M., Wit, S.C. de, Versendaal, H., Weerkamp, F., Henskens, Y.M.C., Scheepers, L.H.C.J., Ham, D.P. van der, Smit, J.W., Graaf, F. van der, Porath, M.M., Salm, P.C.M. van der, Wijnen, M. van, Pontesilli, M., Dunne, F.M. van, Ponjee, G.A.E., Post, M.S., Veen, B.S. van der, Brons, J.T.J., Slomp, J., Mare, A. de, Leyte, A., Akker, E.S.A. van den, Wet, H. de, Borden, D.M.R. van der, Bremer, H.A., Tax, G.H.M., Vries, M.J. de, Boer, K. de, Waard, H. de, Keijzer, R.H. de, Burggraaff, J.M., Pouwels, J.G.J., Gemund, N. van, Prinzen, L., Hendriks, H.A., Hermsen, B.B.J., Koehorst, S.G.A., Verhagen, T.E.M., Beek, E. van, Hackeng, C.M., Kabel, P.J., Steures, P., Dooren, I.A. van, Michielse, E.C.H.J., Chon, H., Treskes, M., Visser, H., Oostenveld, E., Peters, D.H.M., Franssen, M.T.M., Meekers, J.H., Woiski, M.D., Pampus, L.C.M. van, Oudijk, M.A., Vooght, K.M.K. de, Cikot, R.L.M., Mostert, L.J., Ceelie, H., Huijssoon, A.M.G., Groot, C.J.M. de, Visser, O., Jonker, N., Koops, A., Hooker, A., Osmanovic, N., Ulenkate, H.J.L.M., Visschers, B., Martens, G.D.M., TeMpOH-Res Grp
Přispěvatelé: Athena Institute, APH - Global Health, APH - Quality of Care, Reproductive Origins of Adult Health and Disease (ROAHD), Faculteit FHML Centraal, RS: CARIM - R1.04 - Clinical thrombosis and haemostasis, MUMC+: DA CDL Algemeen (9), Med Microbiol, Infect Dis & Infect Prev, Obstetrie & Gynaecologie, MUMC+: MA Medische Staf Obstetrie Gynaecologie (9), RS: GROW - R4 - Reproductive and Perinatal Medicine, RS: Carim - B04 Clinical thrombosis and Haemostasis, Obstetrics & Gynecology
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: TeMpOH-1 Research Group 2019, ' Association of Timing of Plasma Transfusion With Adverse Maternal Outcomes in Women With Persistent Postpartum Hemorrhage ', JAMA Network Open, vol. 2, no. 11, e1915628, pp. 1-16 . https://doi.org/10.1001/jamanetworkopen.2019.15628
JAMA Network Open, 2(11):e1915628, 1-16. American Medical Association
JAMA Network Open
Jama network open, 2(11):1915628. AMER MEDICAL ASSOC
Jama Network Open, 2(11). AMER MEDICAL ASSOC
Jama network open, 2(11):1915628. American Medical Association
JAMA network open, 2(11):e1915628. American Medical Association
ISSN: 2574-3805
DOI: 10.1001/jamanetworkopen.2019.15628
Popis: This cohort study examines the association of timing of receipt of plasma transfusions among women experiencing persistent postpartum hemorrhage with adverse maternal outcomes.
Key Points Question Is plasma transfusion within the first 60 minutes of persistent postpartum hemorrhage (PPH) associated with incidence of maternal adverse outcomes? Findings In this cohort study of 114 propensity score–matched women with persistent PPH, plasma transfusion within the first 60 minutes of persistent PPH was not associated with incidence of maternal adverse outcomes compared with no or later plasma transfusion, independent of severity of PPH at the time of plasma transfusion. Meaning These findings do not support the theory that early plasma transfusion in women with persistent PPH is better than no or later plasma transfusion.
Importance Early plasma transfusion for women with severe postpartum hemorrhage (PPH) is recommended to prevent coagulopathy. However, there is no comparative, quantitative evidence on the association of early plasma transfusion with maternal outcomes. Objective To compare the incidence of adverse maternal outcomes among women who received plasma during the first 60 minutes of persistent PPH vs women who did not receive plasma for similarly severe persistent PPH. Design, Setting, and Participants This multicenter cohort study used a consecutive sample of women with persistent PPH, defined as PPH refractory to first-line measures to control bleeding, between January 1, 2011, and January 1, 2013. Time-dependent propensity score matching was used to select women who received plasma during the first 60 minutes of persistent PPH and match each of them with a woman who had shown the same severity and received the same treatment of PPH but who had not received plasma at the moment of matching. Transfusions were not guided by coagulation tests. Statistical analysis was performed from June 2018 to June 2019. Exposures Transfusion of plasma during the first 60 minutes of persistent PPH vs no or later plasma transfusion. Main Outcomes and Measures Incidence of adverse maternal outcomes, defined as a composite of death, hysterectomy, or arterial embolization. Results This study included 1216 women (mean [SD] age, 31.6 [5.0] years) with persistent PPH, of whom 932 (76.6%) delivered vaginally and 780 (64.1%) had PPH caused by uterine atony. Seven women (0.6%) died because of PPH, 62 women (5.1%) had a hysterectomy, and 159 women (13.1%) had arterial embolizations. Among women who received plasma during the first 60 minutes of persistent PPH, 114 women could be matched with a comparable woman who had not received plasma at the moment of matching. The incidence of adverse maternal outcomes was similar between the women, with adverse outcomes recorded in 24 women (21.2%) who received early plasma transfusion and 23 women (19.9%) who did not receive early plasma transfusion (odds ratio, 1.09; 95% CI, 0.57-2.09). Results of sensitivity analyses were comparable to the primary results. Conclusions and Relevance In this cohort study, initiation of plasma transfusion during the first 60 minutes of persistent PPH was not associated with adverse maternal outcomes compared with no or later plasma transfusion, independent of severity of PPH.
Databáze: OpenAIRE
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