Effect of First Trimester Bleeding on Retained Placenta Requiring Dilatation and Curettage [20OP]
Bibliographic record
Abstract
INTRODUCTION: It is hypothesized that development of early subchorionic hemorrhage may lead to disruption in the placental-uterine matrix resulting in an adherence of the placenta to the endometrium. We sought to evaluate the effect of a first trimester bleed on the need for a post-vaginal delivery D&C for removal of retained placenta. METHODS: We carried out a case-control study at a tertiary care centre in Montréal, Canada between 2012 and 2016. Women identified through medical records as having had a post vaginal delivery D&C for retained placenta were considered cases and matched 2:1 with women delivering vaginally the same day as the case who did not have a retained placenta requiring D&C. Logistic regression evaluated the adjusted effect of a first trimester bleed on the requirement for D&C for retained placenta. RESULTS: There were 68 cases of retained placenta requiring D&C for an estimated 3/1,000 deliveries. Women requiring a D&C for placental removal were slightly older than controls but otherwise comparable in baseline characteristics. First trimester bleeding was more common among women requiring a D&C for retained placenta 11.8% vs 1.5%, respectively. In adjusted analysis, first trimester bleeding was strongly associated with requiring a D&C for removal of retained placenta (OR 7.70, CI 1.37.5). As well, it was associated with a greater postpartum hemorrhage and requirement for blood transfusions. CONCLUSION: First trimester bleeding is associated with a greater risk of retained placenta requiring D&C and blood transfusions. Women with a first trimester bleed should be considered at increased risk of postpartum hemorrhage and retained placenta.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".