Comparison of Blood Loss and Hemoglobin Changes in Induced versus Spontaneous Vaginal Deliveries: A Prospective Observational Study on Postpartum Hemorrhage Risk (Code-T0058)

Background: Postpartum hemorrhage (PPH) is a significant concern during vaginal deliveries, with its incidence differing between spontaneous and induced labors. Accurate measurement of blood loss is crucial for the timely identification and management of PPH. Induction of labor, a frequently performed obstetric procedure, is associated with a heightened risk of excessive bleeding due to factors such as uterine atony and prolonged labor.

Aims & Objectives: This study aims to compare blood loss in induced versus spontaneous vaginal deliveries and to examine the correlation between blood loss and changes in hemoglobin levels before and after delivery.

Methodology: A hospital-based prospective observational study was conducted over 18 months at Fakruddin Ali Ahmed Medical College and Hospital, Barpeta, Assam. A total of 250 primigravida women were divided equally into induced and spontaneous labor groups. Blood loss was measured using a calibrated blood collection bag, and hemoglobin levels were recorded at admission and 24 hours post-delivery. Statistical analyses were conducted to evaluate differences between the groups.

Results: The mean blood loss was significantly higher in the induced labor group (435.6 ± 105.4 ml) compared to the spontaneous labor group (382.7 ± 97.8 ml) (p=0.012). The reduction in hemoglobin levels post-delivery was also greater in the induced group (1.3 ± 0.29 g/dL) compared to the spontaneous group (1.0 ± 0.25 g/dL) (p<0.0001). The need for uterotonics was higher in induced deliveries (30%) compared to spontaneous deliveries (18%), but the difference was not statistically significant.

Conclusion: Induced vaginal deliveries are associated with significantly greater blood loss and a larger reduction in hemoglobin levels than spontaneous deliveries. These findings highlight the importance of close monitoring and proactive management during induced labor to minimize the risk of PPH and its complications.

Keywords: Postpartum hemorrhage, blood loss, induced labor, spontaneous labor, hemoglobin, uterotonics.