Comparison of Postpartum Hemorrhage between Spontaneous and Induced Labor in Term Women Presenting to Shifa International Hospital, Islamabad

Abstract

Background: Postpartum hemorrhage causes significant maternal mortality. In order to control or avoid hemorrhage, risk estimation is necessary. This study compared its frequency in spontaneous and induced labor groups.

Objective: To compare the frequency of postpartum hemorrhage in spontaneous versus induced labor in women delivering at term.

Methodology: Analytical cross-sectional study conducted in the department of Obstetrics and Gynecology, Shifa International Hospital, Islamabad in 6-month from December 2024 to June 2025. A total of 230 patients were equally allocated to either spontaneous labor group or induction of labor group. Study was approved by ethical review board and patients fulfilling inclusion criteria were selected from labor room after a written informed consent. Baseline demographics including age, gestational age, parity, weight, and previous history of postpartum hemorrhage were recorded. Data was collected on a specific proforma and analyzed in SPSS version 26.0.

Results: The mean age was 30.3 ± 5.5 years in induction of labor group and 29.8 ± 3.9 years in spontaneous labor group. The average gestational age at delivery was 39.0 ± 0.9 weeks in induction and 38.4 ± 0.7 weeks in spontaneous labor group. The induced labor group had 8/115 (7.0%) postpartum hemorrhage cases while spontaneous labor group had 4 (3.5%), however, this difference was not significant (p=0.21). There were 27/115 (23.4%) cesarean sections in the induced labor group and 16/115 (13.9%) in the spontaneous group. Postpartum hemorrhage was more frequent in SVD; however, this association was also not statistically proven (p=0.12).

Conclusion: Postpartum hemorrhage is more frequent in females undergoing induced labor compared to spontaneous labor. Moreover, PPH was found more common in SVD than cesarean section, but not statistically proven.