Abstract
BackgroundTo analyze blood loss after delivery in women with induction of labor compared to women with spontaneous onset of labor.MethodsIn this secondary analysis of a prospective cohort study investigating postpartum hemorrhage, 965 deliveries were analyzed including 380 women with induction of labor (39%) between 2015 and 2016. Primary outcome parameters were rate of postpartum hemorrhage, estimated blood loss and post-partum decrease in hemoglobin.ResultsRates of postpartum hemorrhage and estimated blood loss were not significantly different in women with induction of labor. Women with induction of labor had a significantly reduced decrease in hemoglobin after delivery. In the multivariate linear regression analysis, induction of labor remained associated with reduced decrease in hemoglobin. Secondary maternal and neonatal outcomes were unaffected.ConclusionsInduction of labor is not associated with increased blood loss after delivery and should not be regarded as a risk factor for postpartum hemorrhage.
Highlights
To analyze blood loss after delivery in women with induction of labor compared to women with spontaneous onset of labor
Methods for induction of labor (IOL) were oxytocin, misoprostol or both
Incidence of Postpartum hemorrhage (PPH) did not differ between women with IOL compared to women with spontaneous onset of labor (SOL) (24.7% vs. 21.2%, p = 0.20)
Summary
To analyze blood loss after delivery in women with induction of labor compared to women with spontaneous onset of labor. Postpartum Hemorrhage (PPH) is defined by the WHO as blood loss of 500 ml or more within 24 h after birth [1]. Less commonly used definition distinguishes vaginal deliveries (blood loss > 500 ml) from cesarean sections (> 1000 ml) [2]. PPH affects approximately 2% of all women giving birth and remains a leading cause of maternal morbidity (blood transfusion, maternal admission to an intensive care unit [ICU], hysterectomy) and mortality. Average rates of induction of labor (IOL) based on international studies are approximately 20–25% of all pregnancies [5, 6]. Aside from medical reasons, IOL upon maternal request is a common procedure [7]
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