Postpartum bleeding in the context of "Misoprostol"

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⭐ Core Definition: Postpartum bleeding

Postpartum bleeding or postpartum hemorrhage (PPH) is significant blood loss following childbirth. It is the most common cause of maternal death worldwide, disproportionately affecting developing countries. Definitions and criteria for diagnosis are highly variable. PPH is defined by the World Health Organization as "blood loss of 500 ml or more within 24 hours after birth", though signs of shock (insufficient blood flow) have also been used as a definition. Some bleeding after childbirth is normal and is called lochia. It is difficult to distinguish lochia from delayed PPH.

Signs and symptoms of PPH may initially include: an increased heart rate, feeling faint upon standing, and an increased breathing rate. As more blood is lost, the patient may feel cold, blood pressure may drop, and they may become restless or unconscious. In severe cases circulatory collapse, disseminated intravascular coagulation and death can occur. The condition can occur up to twelve weeks following delivery.

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👉 Postpartum bleeding in the context of Misoprostol

Misoprostol is a synthetic prostaglandin medication used to prevent and treat stomach and duodenal ulcers, induce labor, cause an abortion, and treat postpartum bleeding due to poor contraction of the uterus. It is taken by mouth when used to prevent gastric ulcers in people taking nonsteroidal anti-inflammatory drugs (NSAID). For abortions it is typically used in conjunction with mifepristone or methotrexate, but can be used alone. By itself, effectiveness for abortion is between 82% and 100%. Its efficacy with mifepristone is higher, but varies based on gestational age. The misoprostol-only abortion regimen is typically recommended only when mifepristone is not available. For labor induction or abortion, it is taken by mouth, dissolved in the mouth, or placed in the vagina. For postpartum bleeding it may also be used rectally.

Common side effects include diarrhea and abdominal pain. It is in pregnancy category X, meaning that it is known to result in negative outcomes for the fetus if taken during pregnancy. In rare cases, uterine rupture may occur. It is a prostaglandin analogue—specifically, a synthetic prostaglandin E1 (PGE1).

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Postpartum bleeding in the context of Self-managed abortion

A self-induced abortion (also called a self-managed abortion, or sometimes a self-induced miscarriage) is an abortion performed by the pregnant woman herself, or with the help of other, non-medical assistance. Although the term includes abortions induced outside of a clinical setting with legal, sometimes over-the-counter medication, it also refers to efforts to terminate a pregnancy through alternative, potentially more dangerous methods. Such practices may present a threat to the health of women in the case that they are incorrectly used.

Self-induced (or self-managed) abortion is often attempted during the beginning of pregnancy (the first eight weeks from the last menstrual period). In recent years, significant reductions in maternal death and injury resulting from self-induced abortions have been attributed to the increasing availability of misoprostol (known commercially as "Cytotec"). This medication is a synthetic prostaglandin E1 that is inexpensive, widely available, and has multiple uses, including the treatment of post-partum hemorrhage, stomach ulcers, cervical preparation and induction of labor. The World Health Organization (WHO) has endorsed two regimens for abortion up to 12 weeks of pregnancy using misoprostol: a standardized regimen of mifepristone and misoprostol and a regimen of misoprostol alone. The regimen with misoprostol alone has been shown to be up to 83% effective in terminating a pregnancy but is more effective combined with mifepristone.

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