Tendency Prediction for Atonic Bleeding Following a Problem-Free Pregnancy
Bibliographic record
Abstract
Background: The incidence of postpartum hemorrhage (PPH) has increased globally; however, the reasons for this are largely unknown. PPH is potentially fatal and atonic PPH can occur even in low-risk pregnancies. In this study, we aimed to identify the causes of atonic bleeding following a problem-free pregnancy. Methods: One thousand, four hundred sixty-six patients with problem-free pregnancies who experienced total bleeding 2 h after vaginal delivery were divided into two groups based on the amount of blood loss: control group (n = 1,325), with a blood loss of < 800 mL and study group (n = 141) with a blood loss of ≥ 800 mL. Several factors that may correlate with atonic bleeding were divided into three groups: maternal demographic (MD) factors, intrapartum factors, and fatal factors. Comparisons were made between the control group and study group regarding these factors. A multivariate analysis and receiver operating characteristic (ROC) analysis were performed to identify the independent risk factors for atonic bleeding. The continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were also calculated. Results: The independent factors being statistically significant that predicted over 800 mL of atonic bleeding were in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) pregnancies (adjusted odd ratio (OR): 3.63; 95% confidence interval (CI): 2.46 - 5.36; P < 0.001), new-born weight (adjusted OR: 1.0016; 95% CI: 1.0011 - 1.0022; P < 0.001), and the cases of instrumental labor (IL) (adjusted OR: 2.48; 95% CI: 1.64 - 3.77; P < 0.001). ROCs for the final model (area under the curve (AUC): 0.765; 95% CI: 0.724 - 0.806), fatal model (AUC: 0.675; 95% CI: 0.627 - 0.723), intrapartum model (AUC: 0.654; 95% CI: 0.612 - 0.696) and MD model (AUC: 0.615; 95% CI: 0.575 - 0.656) were constructed. The NRI and IDI were 0.733 (95% CI: 0.565 - 0.901; P < 0.0001) and 0.073 (95% CI: 0.051 - 0.90; P < 0.0001) in the fatal model and final model, 0.057 (95% CI: -0.117 - 0.230; P = 0.288) and 0.015 (95% CI: -0.004 - 0.034; P = 0.521) in the MD model, and -0.146 (95% CI: -0.319 - 0.027; P = 0.098) and -0.003 (95% CI: -0.021 - 0.014; P = 0.700) in the intrapartum model. Conclusions: We concluded that IVF/ICSI pregnancies, new-born weight, and IL were independent factors contributing to atonic bleeding. The coincidence of these three factors significantly predicts the likelihood of atonic bleeding. J Clin Gynecol Obstet. 2019;8(2):39-43 doi: https://doi.org/10.14740/jcgo540
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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 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".