{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T16:39:52Z","timestamp":1770741592732,"version":"3.49.0"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Geburtshilfe Neonatol"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The objective of this study was to assess the link between postpartum blood\n                        loss and placental elastography in multiparous pregnancies.<\/jats:p>\n                  <jats:p>In this prospective study, multiparous women who delivered at term between\n                        2020 and 2024 were included. During the obstetric ultrasonography procedure,\n                        placental elastography was evaluated through the utilization of the shear\n                        wave elastography (SWE) technique. Elastographic measurements were performed\n                        at three distinct sites within the anteriorly positioned placentas via the\n                        abdominal route. The mean value of these three sites was subsequently\n                        calculated to derive the Z score. The difference (\u0394) between prepartum and\n                        postpartum hemoglobin values was calculated, and cases with \u0394HB below 2\u2009g\/dl\n                        were considered as the control group, and those with \u0394HB above 2\u2009g\/dl were\n                        considered as the study group. Z scores were then compared between the two\n                        groups.<\/jats:p>\n                  <jats:p>A total of 109 cases was included in the study, 88 (80.7%) of which were\n                        assigned to the control group, and 21 (19.3%) to the study group. Maternal\n                        age (30.4\u00b14.82 vs. 31.7\u00b16.68) and BMI (28.7\u00b13.96 vs. 28.1\u00b14.77 kg\/m2) were\n                        similar in both groups (p&gt;0.05). A positive relationship was identified\n                        between \u0394HB levels and Z score (r=0.521, p&lt;0.001). The optimal cut-off\n                        value for the Z score was determined to be 5.64 kPa, exhibiting 76.2%\n                        sensitivity and 52.3% specificity (AUC: 0.709, p=0.003, 95% CI\n                        0.586-0.833).<\/jats:p>\n                  <jats:p>The elastographic evaluation of the prepartum placenta has the potential to\n                        serve as a valuable tool in estimating postpartum hemoglobin decline.<\/jats:p>","DOI":"10.1055\/a-2680-4676","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T22:47:51Z","timestamp":1757371671000},"page":"44-50","source":"Crossref","is-referenced-by-count":0,"title":["The role of placental elastography in postpartum blood loss in\n                    multiparous pregnancies"],"prefix":"10.1055","volume":"230","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9640-2714","authenticated-orcid":false,"given":"Arife","family":"Akay","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Ministry of\n                    Health Yalova State Hospital, Yalova Merkez, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9345-6899","authenticated-orcid":false,"given":"Y\u0131ld\u0131z","family":"Akda\u015f-Reis","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Etlik Z\u00fcbeyde\n                    Han\u0131m Gynecology and Pediatrics Training and Research Hospital, Ankara,\n                    Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1950-9041","authenticated-orcid":false,"given":"Sait","family":"Erbey","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Etlik Z\u00fcbeyde\n                    Han\u0131m Gynecology and Pediatrics Training and Research Hospital, Ankara,\n                    Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0524-9942","authenticated-orcid":false,"given":"\u00d6zde Beren","family":"Tatar","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Etlik Z\u00fcbeyde\n                    Han\u0131m Gynecology and Pediatrics Training and Research Hospital, Ankara,\n                    Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2869-6914","authenticated-orcid":false,"given":"Elif G\u00fcl\u015fah","family":"Dikta\u015f","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Etlik Z\u00fcbeyde\n                    Han\u0131m Gynecology and Pediatrics Training and Research Hospital, Ankara,\n                    Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7914-3319","authenticated-orcid":false,"given":"Ece Sevin","family":"\u00c7ukurova","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Ministry of\n                    Health Bor State Hospital, Ni\u011fde, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4499-3492","authenticated-orcid":false,"given":"Fahri Bur\u00e7in","family":"F\u0131ratl\u0131gil","sequence":"additional","affiliation":[{"name":"Department of Perinatology, Bilkent City Hospital,\n                    Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9388-0374","authenticated-orcid":false,"given":"Funda","family":"Akp\u0131nar","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, NMC Specialty\n                    Hospital Abu Dhabi, Abu Dhabi, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1111\/1471-0528.12636","article-title":"Postpartum haemorrhage management, risks, and maternal outcomes: findings from\n                    the World Health Organization Multicountry Survey on Maternal and Newborn\n                    Health","volume":"121","author":"W R Sheldon","year":"2014","journal-title":"BJOG"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e0190845","DOI":"10.1371\/journal.pone.0190845","article-title":"Undiagnosed abnormal postpartum blood loss: Incidence and risk factors","volume":"13","author":"A Girault","year":"2018","journal-title":"PLoS One"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1007\/s13224-023-01818-z","article-title":"Peripartum hysterectomy outcomes: Our eleven-year experience at a tertiary care\n                    hospital","volume":"73","author":"A Akay","year":"2023","journal-title":"J Obstet Gynaecol India"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.placenta.2020.07.014","article-title":"The use of elastography in placental research \u2013 A literature review","volume":"99","author":"C Edwards","year":"2020","journal-title":"Placenta"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"106289","DOI":"10.1016\/j.anireprosci.2020.106289","article-title":"Placental ARFI elastography and biometry evaluation in bitches","volume":"214","author":"A P Rodrigues Sim\u00f5es","year":"2020","journal-title":"Anim Reprod Sci"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.1002\/pd.4654","article-title":"Placental elastography in a murine intrauterine growth restriction model","volume":"35","author":"T Quibel","year":"2015","journal-title":"Prenat Diagn"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1686","DOI":"10.1111\/jog.13110","article-title":"Can myometrial elasticity, as determined by elastography at 18\u201322 weeks of\n                    gestation, predict preterm delivery?","volume":"42","author":"H Yilmaz Dogru","year":"2016","journal-title":"J Obstet Gynaecol Res"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"245","DOI":"10.2147\/IJWH.S106321","article-title":"Cervical elastography during pregnancy: clinical perspectives","volume":"9","author":"M Swiatkowska-Freund","year":"2017","journal-title":"Int J Womens Health"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/j.ultras.2014.07.013","article-title":"Quantification of elasticity changes in the myometrium during labor using\n                    Supersonic Shear Imaging: a feasibility study","volume":"56","author":"J L Gennisson","year":"2015","journal-title":"Ultrasonics"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"915","DOI":"10.1016\/j.placenta.2015.06.008","article-title":"Placental elasticity evaluation using virtual touch tissue quantification during\n                    pregnancy","volume":"36","author":"T Ohmaru","year":"2015","journal-title":"Placenta"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2894","DOI":"10.3390\/diagnostics13182894","article-title":"The value of ultrasonic elastography in detecting placental stiffness for the\n                    diagnosis of preeclampsia: A meta-analysis","volume":"13","author":"S Su","year":"2023","journal-title":"Diagnostics (Basel)"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1055\/s-0033-1335205","article-title":"EFSUMB guidelines and recommendations on the clinical use of ultrasound\n                    elastography. Part 1: Basic principles and technology","volume":"34","author":"J Bamber","year":"2013","journal-title":"Ultraschall Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"10420","DOI":"10.1038\/s41598-021-89756-6","article-title":"Using shear wave elastography to assess uterine tonicity after vaginal\n                    delivery","volume":"11","author":"J Sichitiu","year":"2021","journal-title":"Sci Rep"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"102353","DOI":"10.1016\/j.ajp.2020.102353","article-title":"Risk factors for postpartum depression: An evidence-based systematic review of\n                    systematic reviews and meta-analyses","volume":"53","author":"X H Zhao","year":"2020","journal-title":"Asian J Psychiatr"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"102985","DOI":"10.1016\/j.ijoa.2021.102985","article-title":"Antepartum and postpartum anemia: a narrative review","volume":"47","author":"A J Butwick","year":"2021","journal-title":"Int J Obstet Anesth"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1016\/j.semcdb.2022.03.039","article-title":"Human placental development and function","volume":"131","author":"T Cindrova-Davies","year":"2022","journal-title":"Semin Cell Dev Biol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"698","DOI":"10.5858\/arpa.2015-0225-CC","article-title":"Sampling and definitions of placental lesions: Amsterdam Placental Workshop\n                    Group Consensus Statement","volume":"140","author":"T Y Khong","year":"2016","journal-title":"Arch Pathol Lab Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"151","DOI":"10.7863\/ultra.34.1.151","article-title":"Shear wave elastography in placental dysfunction: comparison of elasticity\n                    values in normal and preeclamptic pregnancies in the second trimester","volume":"34","author":"C Cimsit","year":"2015","journal-title":"J Ultrasound Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1159\/000355084","article-title":"Sonoelastography as method for preliminary evaluation of uterine cervix to\n                    predict success of induction of labor","volume":"35","author":"A Muscatello","year":"2014","journal-title":"Fetal Diagn Ther"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.placenta.2022.02.015","article-title":"Relationship between placental elastography, maternal pre-pregnancy body mass\n                    index and gestational weight gain","volume":"121","author":"C Edwards","year":"2022","journal-title":"Placenta"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"4139","DOI":"10.2147\/JMDH.S440448","article-title":"Correlation between postpartum myometrial elasticity and obstetric complications\n                    in pregnant women with gestational diabetes mellitus","volume":"16","author":"J Jin","year":"2023","journal-title":"J Multidiscip Healthc"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1097\/AOG.0000000000004228","article-title":"risk factors for atonic postpartum hemorrhage: A systematic review and\n                    meta-analysis","volume":"137","author":"H B Ende","year":"2021","journal-title":"Obstet Gynecol"}],"container-title":["Zeitschrift f\u00fcr Geburtshilfe und Neonatologie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2680-4676.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:22:11Z","timestamp":1770682931000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2680-4676"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,8]]},"references-count":22,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2026,2,9]]},"published-print":{"date-parts":[[2026,2]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2680-4676","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0948-2393","1439-1651"],"issn-type":[{"value":"0948-2393","type":"print"},{"value":"1439-1651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,8]]}}}