The article below summarizes a roundtable discussion of a study published in this issue of the Journal in light of its methodology, relevance to practice, and implications for future research. Article discussed:
Wright JD, Pri-Paz S, Herzog TJ, et al. Predictors of massive blood loss in women with placenta accreta. Am J Obstet Gynecol 2011;205:38.e1-6.
The full discussion appears at www.AJOG.org , pages e8-10.
Discussion Questions
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What are the advantages and disadvantages of this study design?
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What were the researchers’ primary and secondary objectives?
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What do you think about the variables analyzed?
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How should we view the study’s conclusions?
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Would there be any other way to evaluate this clinical question?
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What is the clinical impact of the study?
Obstetrical hemorrhage is a major cause of maternal morbidity and mortality, with nearly 200,000 annual deaths worldwide attributable to this problem. Abnormal placentation, including placenta accreta, is a common cause. Because the risk for implantation abnormalities rises with each additional cesarean section a woman undergoes, the increasing cesarean rate suggests increasing risk. In a new study by Wright et al, researchers attempted to identify predictors for massive blood loss among patients with placenta accreta.
See related article, page 38