Predicting Intra- and Postpartum Hemorrhage through Artificial Intelligence.

Abstract

Background and Objectives: Intra/postpartum hemorrhage stands as a significant obstetric emergency, ranking among the top five leading causes of maternal mortality. The aim of this study was to assess the predictive performance of four machine learning algorithms for the prediction of postpartum and intrapartum hemorrhage. Materials and Methods: A prospective multicenter study was conducted, involving 203 patients with or without intra/postpartum hemorrhage within the initial 24 h postpartum. The participants were categorized into two groups: those with intra/postpartum hemorrhage (PPH) and those without PPH (control group). The PPH group was further stratified into four classes following the Advanced Trauma Life Support guidelines. Clinical data collected from these patients was included in four machine learning-based algorithms whose predictive performance was assessed. Results: The Naïve Bayes (NB) algorithm exhibited the highest accuracy in predicting PPH, boasting a sensitivity of 96.3% and an accuracy of 98.6%, with a false negative rate of 3.7%. Following closely were the Decision Tree (DT) and Random Forest (RF) algorithms, each achieving sensitivities exceeding 94% with a false negative rate of 5.9%. Regarding severity classification I, the NB and Support Vector Machine (SVM) algorithms demonstrated superior predictive capabilities, achieving a sensitivity of 96.4%, an accuracy of 92.1%, and a false negative rate of 3.6%. The most severe manifestations of HPP were most accurately predicted by the NB algorithm, with a sensitivity of 89.3%, an accuracy of 82.4%, and a false negative rate of 10.7%. Conclusions: The NB algorithm demonstrated the highest accuracy in predicting PPH. A notable discrepancy in algorithm performance was observed between mild and severe forms, with the NB and SVM algorithms displaying superior sensitivity and lower rates of false negatives, particularly for mild forms.