Evaluating Placental Thickness and Thickness of Uterine Muscle at Placenta Attachment in Prediction of Postpartum Blood Loss

Naser, Omar K.; Abdelhamid, Ahmed A.; El-Mashad, Ashraf I.; Tawfik, Waleed M..

doi:10.21608/bmfj.2025.390872.2448

Evaluating Placental Thickness and Thickness of Uterine Muscle at Placenta Attachment in Prediction of Postpartum Blood Loss

Document Type : Original Article

Authors

¹ Lecturer of obstetrics and gynecology Faculty of Medicine - Benha University Faculty of Medicine – Benha National University

² Resident at obstetrics and gynecology department Faculty of Medicine - Benha University

³ Professor of obstetrics and gynecology Faculty of Medicine, Benha University Faculty of Medicine – Benha National University

⁴ Assistant Professor of obstetrics and gynecology Faculty of Medicine - Benha University

10.21608/bmfj.2025.390872.2448

Abstract

Objectives: To determine the significance of the placental thickness, the thickness of the uterine muscle layer at the placental attachment site and the placental myometrial ratio in the prediction of postpartum hemorrhage and to evaluate them as parameters for identifying high-risk patients. Methods: The present prospective observational cohort study involved 150 female patients with full-term pregnancy and single viable fetus. All patients were subjected to postpartum blood loss estimation and correlation between estimated blood loss (EBL) with placental thickness and myometrial ratio were done . Results: Placental thickness, placental-myometrial ratio (PMR) and time of delivery were significantly higher in high-EBL group compared to normal-EBL group. Myometrial thickness was significantly lower in high EBL group than normal EBL one. Multivariate analysis revealed that predictive significance of postpartum blood loss, PMR were the best independent predictors of postpartum blood loss (P<0.05). The ROC curve analysis was conducted for placental thickness, myometrial thickness, and the PMR, revealing optimal cutoff values for predicting postpartum blood loss as >5.47 mm, <1.1 mm, and >5.66mm respectively. These cutoffs corresponded to sensitivities of 75%, 81.25%, and 81.25%, and specificities of 67.16%, 93.28%, and 96.27%. Increased placental thickness and thinning of myometrium are significant predictors of PPH. Conclusion: This study indicates that lower myometrial thickness,larger Placental thickness, increased PMR are significantly linked with prediction of PPH.

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