Evaluation of postpartum blood loss after misoprostol-induced labour

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.