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| Association between the postpartum hemorrhage after cesarean delivery of women with placenta previa and their placental attachment site and the levels of prostaglandin E1 and glutathione peroxidase 1 |
| 1. High Tech Branch, The First Affiliated Hospital of Anhui Medical University, Fuyang City, Anhui Province, 236000；2. Taihe County People's Hospital of Fuyang City |
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Abstract To investigate the association between the postpartum hemorrhage after cesarean delivery of women with placenta previa and their placental attachment site and the levels of prostaglandin E1（PGE1) and glutathione peroxidase 1（GPX1), and to study the diagnostic values of the levels of PGE1) and GPX1 for placenta previa. Methods: From June 2019 to June 2021, 52 women with placenta previa who underwent cesarean section for pregnancy termination were included in observation group, and another 50 women without pregnancy comorbidities who also underwent cesarean section due to maternal pelvis size, fetal size, or maternal hip girth were included in control group. The peripheral venous blood of the women in the two groups was collected immediately after cesarean section, and the serum PGE1 and GPX1 levels of the women were detected. The postpartum hemorrhage of the women were calculated by volumetric method combined with weighing method. The postpartum hemorrhage and the serum PGE1 and GPX1 levels of the women were compared between the two groups, and which of the women with different clinical characteristics in the observation group were also observed and compared. The value of the serum PGE1 and GPX1 levels of the women for predicting their postpartum hemorrhage was analyzed. Results: The levels of serum PGE1 (41.15±10.17 pg/ml) and GPX1 (34.15±3.36 U/L) of the women in the observation group were significantly lower than those (53.64±12.16 pg/ml and 47.45±5.56 U/L) of the women in the control group. The incidence of postpartum hemorrhage (50.0%) of the women in the observation group was significantly higher than that (4.0%) of the women in the control group (P<0.05), the average blood loss (1164.59±179.58 ml) of the women in the observation group was significantly higher than that (619.69±56.69 ml) of the women in the control group. In the observation group, the serum levels of PGE1 and GPX1 of the women with postpartum massive hemorrhage were significantly lower than those of the women without postpartum massive hemorrhage, which of the women with placenta attachment position in the uterine anterior wall, the women with placenta implantation, or the women with central placenta previa were all significantly lower than those of the women without placenta attachment position in the anterior wall, the women without placenta implantation, or the women without central placenta previa. In the observation group, the average postpartum blood loss of the women with placenta attachment position in the uterine anterior wall, the women with placenta implantation, or the women with central placenta previa was all significantly higher than those of the women without placenta attachment position in the anterior wall, the women without placenta implantation, or the women without central placenta previa (all P<0.05). Pearson linear correlation analysis showed that the serum PGE1 and GPX1 levels of the women with placenta previa after cesarean section were negatively correlated with their postpartum blood loss (P<0.05). Drawing receiver operating characteristic curve, the postpartum serum PGE1 level (AUC=0.759) and the GPX1 level (AUC=0.749) of the women with placenta previa had certain value efficacy for predicting their postpartum hemorrhage, and the combined levels of the serum PGE1 and GPX1 had the best predicted efficacy for postpartum hemorrhage (AUC=0.826). Conclusion: Detection of the serum PGE1 and GPX1 levels of the women with placenta previa after cesarean section has certain guiding significance in evaluating their postpartum hemorrhage in clinic.
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