Evaluation of postpartum blood loss after misoprostol-induced labour

Authors

  • MShE Elsedeek,

    Corresponding author
    1. Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
    2. Department of Obstetrics and Gynecology, Shatby Maternity University Hospital, Alexandria, Egypt
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  • EE Awad,

    1. Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
    2. Department of Obstetrics and Gynecology, Shatby Maternity University Hospital, Alexandria, Egypt
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  • SM Elsebaey

    1. Department of Obstetrics and Gynecology, Shatby Maternity University Hospital, Alexandria, Egypt
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Dr MSE ElSedeek, Shatby Maternity University Hospital, Alexandria 03312, Egypt. Email mervatsheikh@yahoo.com

Abstract

Objective  To objectively evaluate postpartum blood loss after successful misoprostol induction and compare it with blood loss after oxytocin induction of labour.

Design  Prospective randomised study.

Setting  Labour ward in university maternity hospital.

Population  A total of 150 women up to third parity with completed 40 weeks of singleton normal pregnancy, average size cephalic fetus.

Methods  Cases were randomised between oxytocin induction and misoprostol induction. Blood was collected in suction set and measured in the delivery room starting after delivery of the fetus and was evaluated by pad weighing in the following 6 hours. Pre- and postdelivery haematocrit were measured and difference between the two values was assessed and analysed.

Main outcome measures  Success of induction, induction delivery interval, postpartum blood loss, and difference between pre- and postdelivery haematocrit.

Results  Induced labour was significantly faster with misoprostol induction (P < 0.001). Blood loss and haematocrit difference was significantly greater in the misoprostol group than in oxytocin group (P < 0.02 and 0.001, respectively). Blood loss in both groups was significantly correlated with higher initial Bishop score (P < 0.001 and 0.024, respectively) and short labour duration (P < 0.0002 and 0.0001, respectively).

Conclusions  Misoprostol induction is associated with increased blood loss especially when used in women with high Bishop score; therefore, it is better reserved for cases requiring cervical ripening.

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