Comparison of Postpartum Hemoglobin and Hematocrit Levels In Conventional and Physiological Delivery in Iran: A Quasi-Experimental Study

Abstract

Background: Despite the great importance of controlling and preventing postpartum hemorrhage, no evidence has been provided to reduce postpartum hemorrhage physiologically compared to conventional vaginal delivery. While it is claimed that physiological delivery can be better than conventional delivery, in many ways, there is insufficient available information about the effect of the delivery method on postpartum hemoglobin and hematocrit levels. Objective: The current study aimed to compare postpartum hemoglobin and hematocrit levels in conventional and physiological delivery methods in Fatemieh Hospital of Hamedan. Methods: This quasi-experimental study was conducted on 400 pregnant women candidates for physiological delivery and 400 pregnant women for conventional vaginal delivery in 2019. Mothers in the physiological delivery group were provided with the necessary training. In the conventional vaginal delivery group, the mother went through the usual procedures upon hospitalization. All mothers' venous blood samples were analyzed for hemoglobin and hematocrit levels at the time of hospitalization and six hours after delivery. The significance level was considered at p = 0.05. Results: The outcomes indicated that by controlling the confounding variables, the mean of hemoglobin in the physiologic delivery group was significantly higher than conventional vaginal delivery, 11.93 (1.20) and 11.64 (1.20) respectively (P <0.001), but the Cohen's d value of 0.25 indicated a weak relationship between the mean of hemoglobin level six hours after delivery and the type of delivery. The results also indicated that by controlling the effect of confounding variables, the mean of hematocrit in the physiological group was significantly more than conventional vaginal delivery (36.53 (3.33) and 35.50 (3.33) respectively) (p <0.001) but the Cohen's d value of 0.31 indicates a weak relationship between mean hematocrit 6 hours after delivery and the type of delivery. Conclusions: The results indicated that physiologic delivery did not show a valuable/considerable or the expected effect on improving postpartum maternal hemoglobin and hematocrit levels comparing to conventional delivery.