{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T18:22:37Z","timestamp":1790792557082,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T00:00:00Z","timestamp":1691539200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe the shock index (SI) distribution during the first 2\u2009hours after delivery and to evaluate its performance when measured 15 and 30\u2009minutes after delivery for predicting postpartum haemorrhage (PPH) occurrence in the general population of parturients after vaginal delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Secondary analysis of a multicentre randomised controlled trial testing prophylactic administration of tranexamic acid versus placebo in addition to prophylactic oxytocin to prevent PPH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>15 French maternity units in 2015\u20132016.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>3891 women with a singleton live fetus \u226535\u2009weeks, born vaginally.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>For each PPH\u2010related predicted outcome, we calculated the area under the receiver operating characteristic curve (AUROC) values of the SI at 15 and 30\u2009minutes after delivery and its predictive performance for SI cut\u2010off values of 0.7, 0.9 and 1.1.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Quantitative blood loss \u22651000\u2009ml (QBL \u22651000\u2009ml) measured in a graduated collector bag and provider\u2010assessed clinically significant PPH (cPPH).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Prevalence of QBL \u22651000\u2009ml and cPPH was respectively 2.7% (104\/3839) and 9.1% (354\/3891). The distributions of the SI at 15 and 30\u2009minutes after delivery were similar with a median value of 0.73 and 97th percentile of 1.11 for both. The AUROC values of the 15\u2010minute SI for discriminating QBL \u22651000\u2009ml and cPPH were respectively 0.66 (lower limit of the 95% confidence interval [LCI] 0.60) and 0.56 (LCI 0.52); and for the 30\u2010minute SI 0.68 (LCI 0.61) and 0.49 (LCI 0.43).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The shock index at 15 and 30\u2009minutes after delivery did not satisfactorily predict either QBL \u22651000\u2009ml or clinical PPH.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17634","type":"journal-article","created":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T10:00:26Z","timestamp":1691575226000},"page":"343-352","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Shock index as a predictor of postpartum haemorrhage after vaginal delivery: Secondary analysis of a multicentre randomised controlled 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