Can the Induction of Labor with Misoprostol Increase Maternal Blood Loss?

Abstract

Keywords► induced labor ► misoprostol ► postpartum hemorrhage ► hemoglobin ► vaginal birth AbstractPurpose To evaluate blood loss during misoprostol-induced vaginal births and during cesarean sections after attempted misoprostol induction. Methods We 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). Results There were significant differences between pre-and postpartum hemoglobin levels (p < 0.0001) with regard to misoprostol-induced vaginal deliveries (1.6 AE 1.4 mg/dL), non-induced vaginal deliveries (1.4 AE 1.0 mg/dL), cesarean sections after attempted misoprostol induction (1.5 AE 1.0 mg/dL), and elective cesarean deliveries (1.8 AE 1.1 mg/dL). However, the differences were proportional between the groups with and without misoprostol administration, for both cesarean (p ¼ 0.6845) and vaginal deliveries (p ¼ 0.2694). Conclusions Labor induction using misoprostol did not affect blood loss during delivery.