Innovative CT Indicator Enhances Prediction of Critical Postpartum Bleeding Risks
A new CT imaging pattern called PRACE enables early prediction of severe postpartum hemorrhage cases likely to need life-saving interventions, improving maternal care outcomes.
Researchers from Kumamoto University have uncovered a novel CT imaging pattern, named PRACE (Postpartum hemorrhage, Resistance to treatment, and Arterial Contrast Extravasation), which can reliably predict severe postpartum hemorrhage (PPH) cases requiring emergency intervention. The study analyzed 352 cases across 43 Japanese medical centers, with 205 patients undergoing dynamic CT scans. Notably, 58 of these patients (32.2%) exhibited the PRACE pattern, characterized by early-phase contrast leakage into the uterine cavity indicating active arterial bleeding.
The presence of PRACE was associated with a significantly higher likelihood of needing uterine artery embolization (UAE), with over 86% of affected women requiring this procedure compared to less than 29% of women without PRACE. Furthermore, patients with this imaging pattern faced increased risks of blood clotting disorders and higher transfusion volumes. The odds ratio indicated that PRACE was the strongest predictor for the necessity of UAEs, with an OR of 27.74.
This breakthrough offers a promising tool in emergency obstetric care. Dynamic CT imaging now facilitates early detection of treatment-resistant postpartum bleeding, allowing clinicians to respond swiftly. Eiji Kondoh, a professor at Kumamoto University, emphasized the significance: "PRACE is a game-changer in assessing and managing critical postpartum hemorrhage, enabling timely interventions and potentially saving lives."
The findings suggest that integrating dynamic CT into standard protocols could substantially improve maternal outcomes. The researchers also recommend revising the traditional '4 Ts' classification of PPH to include a fifth component—‘CT findings’—for better risk stratification. This development represents a significant step forward in maternal health diagnostics, expanding the capacity to predict and treat severe postpartum bleeding effectively.
For more details, refer to the original study published in JAMA Network Open: Munekage Yamaguchi et al, 2025. Source: https://medicalxpress.com/news/2025-08-ct-based-indicator-doctors-life.html
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