Can the Induction of Labor with Misoprostol Increase Maternal Blood Loss?
PurposeTo evaluate blood loss during misoprostol-induced vaginal births and during cesarean sections after attempted misoprostol induction.MethodsWe conducted a prospective observational study in 101 pregnant women indicated for labor induction; pre- and postpartum hemoglobin levels were measured to estimate blood loss during delivery. Labor was induced by administering 25 µg vaginal misoprostol every 6 hours (with a maximum of 6 doses). The control group included 30 patients who spontaneously entered labor, and 30 patients who underwent elective cesarean section. Pre- and postpartum hemoglobin levels were evaluated using the analysis of variance for repeated measurements, showing the effects of time (pre- and postpartum) and of the group (with and without misoprostol administration).ResultsThere were significant differences between pre- and postpartum hemoglobin levels (p< 0.0001) with regard to misoprostol-induced vaginal deliveries (1.6 ± 1.4 mg/dL), non-induced vaginal deliveries (1.4 ± 1.0 mg/dL), cesarean sections after attempted misoprostol induction (1.5 ± 1.0 mg/dL), and elective cesarean deliveries (1.8 ± 1.1 mg/dL). However, the differences were proportional between the groups with and without misoprostol administration, for both cesarean (p= 0.6845) and vaginal deliveries (p= 0.2694).ConclusionsLabor induction using misoprostol did not affect blood loss during delivery.
Obstetrics Sector, Maternidade Escola Assis Chateaubriand, Universidade Federal do Ceará (UFC), Fortaleza-CE, Brazil.
Paulo César Praciano
PC
Souza
Obstetrics Sector, Maternidade Escola Assis Chateaubriand, Universidade Federal do Ceará (UFC), Fortaleza-CE, Brazil.
Karla Santana Azevedo
KS
Damasceno
Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP), São Paulo-SP, Brazil.
Edward
E
Araujo Júnior
Obstetrics Sector, Maternidade Escola Assis Chateaubriand, Universidade Federal do Ceará (UFC), Fortaleza-CE, Brazil.
Carlos Augusto
CA
Alencar Júnior
Obstetrics Sector, Maternidade Escola Assis Chateaubriand, Universidade Federal do Ceará (UFC), Fortaleza-CE, Brazil.
Francisco Edson de Lucena
FE
Feitosa
D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D016595:Misoprostol / Q000009:adverse effects*; D010120:Oxytocics / Q000009:adverse effects*; D006473:Postpartum Hemorrhage / Q000139:chemically induced*; D011247:Pregnancy; D011446:Prospective Studies; D055815:Young Adult
D010120:Oxytocics; D016595:Misoprostol