Raised nitric oxide levels may cause atonic postpartum hemorrhage in women with anemia during pregnancy

Soltan MH et al. – Even moderate anemia can raise levels of NO and enhance its biologic effects, which in turn can result in uterine muscle relaxation and atonic postpartum hemorrhage (PPH). Preventing or treating anemia during pregnancy could avoid these complications.
Methods

• Of 319 women admitted to the Department of Obstetrics and Gynecology, Dayrout General Hospital, Assiut, Egypt, for delivery in July 2010, 200, who were not considered to be at risk of atonic PPH, were eligible for inclusion.
• Plasma levels of Hb and nitrite were measured on admission.
• The third stage of labor was actively managed.

Results

• A total of 22 participants had significantly raised PN levels (P<0.001), 12 of whom developed PPH—with Hb levels of 9g/dL or less and nitric oxide (NO) levels of 180μM/L or greater.
• The other 10 women underwent over 6hours of stressful labor prior to hospital admission.

International Journal of Gynecology & Obstetrics, 11/28/2011