Inability to predict postpartum hemorrhage: insights from Egyptian intervention data

<p>Abstract</p> <p>Background</p> <p>Knowledge on how well we can predict primary postpartum hemorrhage (PPH) can help policy makers and health providers design current delivery protocols and PPH case management. The purpose of this paper is to identify risk factors and determine predictive probabilities of those risk factors for primary PPH among women expecting singleton vaginal deliveries in Egypt.</p> <p>Methods</p> <p>From a prospective cohort study, 2510 pregnant women were recruited over a six-month period in Egypt in 2004. PPH was defined as blood loss ≥ 500 ml. Measures of blood loss were made every 20 minutes for the first 4 hours after delivery using a calibrated under the buttocks drape. Using all variables available in the patients' charts, we divided them in ante-partum and intra-partum factors. We employed logistic regression to analyze socio-demographic, medical and past obstetric history, and labor and delivery outcomes as potential PPH risk factors. Post-model predicted probabilities were estimated using the identified risk factors.</p> <p>Results</p> <p>We found a total of 93 cases of primary PPH. In multivariate models, ante-partum hemoglobin, history of previous PPH, labor augmentation and prolonged labor were significantly associated with PPH. Post model probability estimates showed that even among women with three or more risk factors, PPH could only be predicted in 10% of the cases.</p> <p>Conclusions</p> <p>The predictive probability of ante-partum and intra-partum risk factors for PPH is very low. Prevention of PPH to all women is highly recommended.</p

Investigations of the Uranium distribution in flint

International audienc

Luminescence dates for the Paleoindian site of Pedra Pintada, Brazil

International audienceDates are presented for the Paleoindian levels of Pedra Pintada cave in Brazil, based on the thermoluminescence (TL) and optically stimulated luminescence (OSL) study of ten specimens of heated siliceous stones and three of sand, respectively. Also discussed are the details of preliminary mineralogical, radiographic, and analytical work done on the lithic specimens in France and the OSL work done on the sediments in the US. The luminescence dates are in agreement with radiocarbon dates for the same strata

TL dating of burnt lithics from Blombos cave (South Africa): further evidence for the antiquity of modern human behaviour

International audienceThis paper presents the first TL dates for burnt quartzites and silcretes from the Still Bay layers of Blombos Cave (South Africa). These layers contained engraved ochres and marine shell beads that could be an early manifestation of symbolic and thus ‘modern’ behaviour by the Middle Stone Age humans. The procedure devised to calculate the ages is presented in detail, particularly with regard to internal microdosimetry, because the problems faced in estimating the dose rates require an approach different from the one usually used on flints and sediments. A mean age of 74 ± 5 ka was obtained for five burnt lithics unearthed in the BBC M1 member of the Still Bay layers. This result is in good agreement with both ESR dates on teeth and OSL dates on sediment, and demonstrates the great antiquity of the archaeological remains discovered at Blombos Cave

TL dating of burnt lithics from Blombos cave (South Africa): further evidence for the antiquity of modern human behaviour

International audienceThis paper presents the first TL dates for burnt quartzites and silcretes from the Still Bay layers of Blombos Cave (South Africa). These layers contained engraved ochres and marine shell beads that could be an early manifestation of symbolic and thus ‘modern’ behaviour by the Middle Stone Age humans. The procedure devised to calculate the ages is presented in detail, particularly with regard to internal microdosimetry, because the problems faced in estimating the dose rates require an approach different from the one usually used on flints and sediments. A mean age of 74 ± 5 ka was obtained for five burnt lithics unearthed in the BBC M1 member of the Still Bay layers. This result is in good agreement with both ESR dates on teeth and OSL dates on sediment, and demonstrates the great antiquity of the archaeological remains discovered at Blombos Cave