Abstract
ABSTRACTObjective To characterize the use of the drug misoprostol for treatment of postpartum hemorrhage in pregnant women.Methods A descriptive observational study was carried out with secondary data from pregnant women who used misoprostol to treat postpartum hemorrhage in a reference public maternity, from July 2015 to June 2017. Clinical and sociodemographic profiles of pregnant women, how misoprostol was used and success rate in controling postpartum hemorrhage were characterized.Results A total of 717 prescriptions of misoprostol were identified. Of these, 10% were for treatment of postpartum hemorrhage. The majority of pregnant women were young adults, married, with complete high school education, white, residing in urban areas, multiparous (68.1%) and 25% had previous cesarean sections. The mean gestational age was 39 weeks and 51.4% had a cesarean section. There was prophylactic use of oxytocin in 47.2% of women. Treatment of postpartum hemorrhage was successful in 84.7% of women. Of these, 79.2% also used oxytocin and 54.2% methylergonovine. Only 13.5% of pregnant women had less than five prenatal visits, and the main cause of postpartum hemorrhage was uterine atony. There were 13 complications after hemorrhage, 15.3% required blood transfusion and there was one case of maternal death.Conclusion Misoprostol showed to be effective and safe for treating postpartum hemorrhage.
Highlights
According to the World Health Organization (WHO), postpartum hemorrhage (PPH) is the cause of approximately 25% of all deaths of pregnant women all over the world, especially in low-income countries. It is responsible for the majority of severe maternal morbidities, such as prolonged hospital admissions, need for blood transfusions and surgical procedures that can lead to loss of reproductive function.[1]. In Brazil, bleeding is the second leading cause of maternal death, and PPH accounts for 40.8% of total number of obstetric hemorrhages.[2]
A cross-sectional descriptive observational study aimed to study the pattern of use and success rate of misoprostol for treating PPH in all pregnant women who used this drug at a maternity hospital in the State of Paraná, Brazil
Misoprostol was given to 717 pregnant women, of whom 362 received the medication to induce delivery with live fetus (50.5%), 283 to manage abortion and pregnancy termination with retained dead fetus (39.5%), and 72 to treat PPH (10.0%)
Summary
According to the World Health Organization (WHO), postpartum hemorrhage (PPH) is the cause of approximately 25% of all deaths of pregnant women all over the world, especially in low-income countries It is responsible for the majority of severe maternal morbidities, such as prolonged hospital admissions, need for blood transfusions and surgical procedures that can lead to loss of reproductive function.[1] In Brazil, bleeding is the second leading cause of maternal death, and PPH accounts for 40.8% of total number of obstetric hemorrhages.[2]. Most of those deaths can be avoided by prophylactic use of oxytocic agents during the third stage of delivery and rapid and appropriate management of bleeding. Prostaglandin or its analogs, such as misoprostol, is used.[2,5]
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