new Study Suggests oral Misoprostol May reduce Postpartum Hemorrhage Risk in Late-Term Pregnancies
A recent study published in BMC Pregnancy and Childbirth indicates that low-dose oral misoprostol may be associated with a lower risk of postpartum hemorrhage (PPH) compared to oxytocin when used for labor induction in women with premature rupture of membranes (PROM) at or beyond 36 weeks of gestation. Researchers found that misoprostol administration correlated with a significantly reduced likelihood of PPH (aOR = 0.42, 95% CI: 0.23 to 0.76, p* < 0.01).
The study compared outcomes of labor induction using either oral misoprostol or oxytocin infusion in a cohort of pregnant women experiencing PROM at ≥36 weeks. While height (aOR: 1.10, 95% CI: 1.05 to 1.15, *p < 0.01) and Bishop score (aOR: 1.25, 95% CI: 1.02 to 1.54, p* = 0.03) were positively associated with successful vaginal delivery, higher pregestational BMI (aOR: 0.86, 95% CI: 0.75 to 0.99, *p = 0.03) and gestational weeks (aOR: 0.69, 95% CI: 0.50 to 0.94, p* = 0.02) were negatively associated with it.
Further analysis revealed differing risk factors for failed induction of labor depending on the drug used. In the oxytocin group, in-vitro fertilization/embryo transfer (IVF-ET) (aOR: 4.46, 95% CI: 1.39 to 14.18,*P = 0.01) and high birth weight (aOR: 1.002, 95% CI: 1.000 to 1.004, P* = 0.02) were notable risk factors. conversely, in the misoprostol group, a low Bishop score (aOR: 0.65, 95% CI: 0.43 to 0.96, *P = 0.03) and early gestational age (aOR: 0.65, 95% CI: 0.43 to 0.96, P* = 0.03) increased the risk of failed induction. Higher pregestational BMI (aOR: 1.10, 95% CI: 1.00 to 1.20, *p = 0.04) was associated with failed induction overall.