Maternal Outcomes of Induced Versus ‎Spontaneous Labor among Admitted Women in Delivery Room at Maternity Teaching Hospital in Erbil City: A Comparative ‎Study

Maternal Outcomes of Induced Versus ‎Spontaneous Labor among Admitted Women in Delivery Room at Maternity Teaching Hospital in Erbil City: A Comparative ‎Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Maternal Outcomes of Induced Versus ‎Spontaneous Labor among Admitted Women in Delivery Room at Maternity Teaching Hospital in Erbil City: A Comparative ‎Study Awaz saeed, Bewar Husamaaldin Noori This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2696062/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background and objectives : Induction of labor refers to the stimulation of contractions ‎before the labor starts spontaneously, with or without ruptured membranes. The aim of the present study was to compare the ‎maternal outcomes of induced versus spontaneous labor.‎ Methods : A comparative study was conducted in Maternity Teaching Hospital in Erbil ‎city from ‎February 2020 to February 2021. Using purposive (non-probability) ‎sampling techniques, ‎‎240 pregnant women (120 with induced labor and 120 with spontaneous ‎labor) were recruited into the study. Through direct interviews, a proper researcher-designed questionnaire ‎was ‎utilized to collect required data. ‎The collected data were ‎analyzed using descriptive and inferential statistical approaches.‎ Results : There were significant to ‎highly significant differences between the two delivery methods in terms of maternal outcomes, ‎emergency cesarean section, postpartum blood loss, need for blood ‎transfusion, uterine ‎atony, perennial laceration, and postpartum hospital stay.‎ ‎ Conclusions : There were the significance to highly significance difference of the ‎maternal ‎outcomes between induced and spontaneous labor. induction of labor spontaneous labor outcome Introduction Spontaneous labor refers to a birth without clinical intervention and the pregnant women they do not have induction of labor, epidural anesthesia, ‎spinal anesthesia, general anesthesia, assisted vaginal delivery (with forceps and/or ventouse), and cesarean delivery. Women will experience spontaneous labor if they do not take ‎prostaglandins, oxytocin, artificial rupture of membrane, or balloon catheters for the purpose of labor induction (Prosser ‎et al , 2018).‎ Induction of labor is a procedure used to stimulate uterine contractions during pregnancy before labor begins on its own, and it initiates when a birth benefits the mother or the fetus and compensates for the risks of a continuing pregnancy (Wing and Sheibani, 2015 ). Induction of labor often begins with cervical ripening which includes softening and loosening of the cervix in the preparation for labor and delivery (Sciscione et al , 2014). Cervical ripening is defined as the precursor to the onset of labor, in which the cervix becomes soft, either naturally or as a result of physical or pharmacological interventions (Banos et al, 2015 ). Indications for induction of labor include postdate (Rampersad et al, 2018 ), gestational hypertension, chorioamnionitis, premature rupture of membrane, preeclampsia, maternal conditions (e.g., chronic hypertension and diabetes mellitus), and neonate conditions (e.g., oligohydramnios and severe neonate growth restriction) (Viteri and Sibai, 2018 ). Both pharmacological (prostaglandins and oxytocin) and mechanical (balloon catheters) agents are used for induction of labor (Levine, 2016). When these methods are used individually, the incidence of cesarean delivery decreases in women undergoing induction (Mizrachi et al., 2016 ). Oxytocin, the hormone that stimulates uterine contractions, is less effective in cervical ripening and is usually used alone to induce labor when the cervix is ​​favorable (Bishop's degree > 6) or after cervical ripening by prostaglandins or mechanical methods (Penfield and Wing, 2017 ). Misoprostol (prostaglandin E1 analog) is broadly used to induce labor (Viteri and Sibai, 2018 ). Induction of labor brings about many potential complications for mothers and newborns, while mechanical methods are associated with the fewest number of harmful effects (Penfield and Wing, 2017 ). Women undergoing induction of labor may be at a higher risk of cesarean section (Saccone and Berghella, 2015 ). Pharmacological methods of induction of labor are associated with possible risks, such as uterine tachysystole with or without changing the neonate heart rate, uterine rupture, fetus distress, and maternal morbidity and mortality. The incidence of these adverse events is dependent on the agent used for induction, dose, and other factors (Knight et al, 2017 ). Induction of the postdate has been found to be associated with an increased risk of overall C/S due to failure to progress, chorioamnionitis, labor dystocia, uterine rupture, reduced risk of developing oligohydramnios, and meconium-stained amniotic fluid. Induction of labor does not cause postpartum hemorrhage, shoulder dystocia, or meconium aspiration (Rydahl et al, 2019 ).‎ Induction of labor at 39 weeks of gestation results in lower rates of cesarean delivery, maternal morbidity, newborn morbidity, stillbirths, and newborn deaths (Sinkey et al, 2019 ). Induction of labor represents the most common interventional procedure in obstetrics. It is applied in 20–25% of all pregnancies in Korea (Kim et al., 2019 ). The prevalence of induction of labor in Finland is very low compared to other developed countries, and the rate of successful induction in Finland is slightly higher than Ethiopia but is comparable to regional rates when induction failure is very low compared to local and regional institutions. Bishop score, which is based on cervical favorability before induction, has been used to predict whether induction of labor leads to a successful vaginal delivery or not. Low cervical score has been associated with failure of induction, prolonged labor, and a high rate of cesarean deliveries (Khandelwal et al 2018 ). Bishop's score is a remarkable predictor for success of induction (Lueth et al, 2020 ). In the United States of America and the United Kingdom, about 23% of all deliveries are by induction of labor, while the counterpart figure in Latin America is 11.4% (Guerra et al 2017 ). Methods Using a quantitative comparative design, the present study was conducted among full-term pregnant women admitted to the Maternity Teaching ‎Hospital in Erbil city from February 2020 to February 2021 .The ethical approval has been obtained from the ethical approval committee of Hawler Medical University /Nursing college that consists of (Assistant .Prof DR. Siyamand Hasan Muhedin)(,Assistant.Prof DR..Runak Neamatulla Husin),( L.DR..Zhyan Abdulla) (,L.Salar Saidi Husin ),(L.Banaz sediq Smail) and the head of committee (Assistant Prof. Dr.Abdulqader Husin ) Then a verbal consent has been obtained from the samples after informed them about the questionnaire items, We didn’t need written consent from participants because we dealing with them by asking questions they answer after getting agreement from them this is allowed by our university, the ethical committee in nursing college(Assistant .Prof DR. Siyamand Hasan Muhedin)(,Assistant.Prof DR..Runak Neamatulla Husin),( L.DR..Zhyan Abdulla) (,L.Salar Saidi Husin ),(L.Banaz sediq Smail) and the head of committee (Assistant Prof. Dr.Abdulqader Husin ) approved that, in case of dealing with participants by drugs ,substances, herbal and some kinds of food need written consent. The guidelines outlined in the Declaration of Helsinki were followed for the participants in order to didn’t expose them to any risk. The sample size was determined by power and sample size estimation software (Version 3.0.43). ‎For this purpose, the following data were fed into the software: The rate of vaginal delivery which was set at 83.6% and 67.6% ‎among the spontaneous labor group and the induction ‎group, respectively (Abisowo et al, 2017 ), the alpha error that was set at 0.05, and the beta error that was set at 20% (power 80%). ‎Accordingly, the estimated sample size was 112 women in the spontaneous labor group and 112 women ‎in the induced labor group. Therefore, 240 women were recruited: 120 women for the induced group and ‎‎120 for the spontaneous group. ‎The inclusion criteria were live singleton fetus, vertex presentation, gestational age after 37 gestational weeks, cases indicated to induction of labor (in induced group), and uncomplicated cases (convulsion, severe bleeding, and shock). The exclusion criteria were mal-presentation, ‎abnormal placentation,‎‎ intrauterine neonate death, gestational age less than 37 gestational weeks,‎ women who did not have a chronic disease ‎or any medical problems, previous cesarean section, uncooperative patient, ‎multiple pregnancies. Required data were gathered through a proper questionnaire aimed at collecting data on the pregnant women’s socio-demographic characteristics. The questionnaire consisted of two sections. Section 1 was used to gather data on the pregnant women’s demographic characteristics, including age ‎‎(classified into 16–23, 24–31, 32–39, and > 40 age groups), educational level (including illiterate, able to read and write, primary ‎school, secondary school, and college or institute), residency (including urban, suburban, and rural), occupation ‎‎(including government employee, private employee, self-employment, student, and housewife), income, smoking, and secondary smoker. ‎Section 2 was utilized to collect data on anthropometric measurement, BMI according to the World Health Organization (WHO, 2011) (BMI was classified as follows: Underweight < 18.5 kg/m², Normal weight 18.5–24.9 kg/m², Overweight 25.0-29.9 kg/m², Moderate obesity (class I) 30.0–34.9 kg/m², Severe (gross) obesity (class II) 35.0–39.9 kg/m², and Very severe (morbid) obesity (class III) ≥ 40 kg/m²), and maternal outcomes (including emergency cesarean section delivery, blood loss‎, need for blood transfusion, uterine atony, need for uterotonics after delivery, perennial laceration, postpartum stay in hospital, admission to ICU, hysterectomy, and status at ‎discharge). Results Table 1 shows the demographic data obtained from the study participants with induced and spontaneous ‎labor. As indicated, about half of the induced group (49.1%) aged between 16 and 23 ‎years, and (43.3%) of the spontaneous group aged between 24 and 31 years. ‎Regarding the educational level, (26.6%) of the women in the induced group were primary school graduated, and (30%) in the spontaneous group were illiterate. Most of the women in the induced group (45%) lived in rural areas, and (43.3%) in the spontaneous group ‎lived in urban areas.‎‎ Regarding their occupation, most of the women in both ‎study groups (97.5%) were housewives. The results revealed that (76.7%) women in the induced group and (70%) in the spontaneous group were not satisfied with their income. Regarding their BMI, (34.2%) of the women in the induced and spontaneous groups were ‎overweight. In terms of their smoking status, non-smokers made up the majority proportion (96.7%) of the induced women and (100%) of the spontaneous women; however, (50.8%) of the women in the induced group and (63.3%) in the spontaneous group were secondary smokers.‎ Table 2 shows the differences between maternal outcomes regarding methods of labor (induced and ‎spontaneous labor).‎There were significance to highly significance difference between the ‎scores of the items of the maternal outcomes (Emergency C/S, vital sings, Amount of blood loss after delivery, Blood Transfusion Needed, number of Blood Pints, Uterine atony , Perennial Laceration, Postpartum Stay) with regards to the method of delivery ‎‎(induced and spontaneous labor) except the items; (postpartum uterotonic use, ICU admission, admission ‎causes, hysterectomy, and pt. discharge status) which they were not computed ‎because similar answer in both groups. Discusion Table 1 Analyzing the data on the women's demographic variables revealed that nearly half of the women in the induced group aged 16–23 years, while the majority of the women in the spontaneous group aged 24–‎‎31 years. These results are consistent with the study conducted in Italy by Poma et al (2017) ‎who reported the majority of the participants in the induced group were within the age group of 16–23 years and 24–31 years in the spontaneous group.‎ Percentage distribution of the women's level of education revealed that the ‎majority of the induced group were primary school graduates. This finding is inconsistent with ‎the results of the previous study carried out in Nigeria by Lawani et al (2014) who reported that the majority of ‎the induced group were tertiary graduates. The present study showed that the majority of the women in the spontaneous ‎group were illiterate. This finding is line with that of the study conducted by Tarimo et al (2020) who ‎reported similar results.‎ According to the data on the women's residency, a large proportion of the induced women lived in rural areas. This finding disagrees with those of a descriptive observational study which was conducted in Sulaymaniyah City, ‎Iraq by Mohammed (2020) who reported that the majority of the induced group lived in urban areas. It also disagrees with the results of a study carried out in Ethiopia which indicated that the majority of the induced group lived in ‎urban areas (Lueth et al 2020). However, a large proportion of the women in spontaneous group lived in urban areas. This finding is in disagreement with those of the study conducted in Spain by Marco-Gracia (2019) who found that the highest proportion of the women resided rural areas. Concerning the participants' occupation, the results of the current study indicated that ‎the highest proportion of both study groups were housewives. This finding is persistent with those of an earlier ‎study conducted by Yisma et al (2020) who demonstrated similar results. Similarly, the results of another study ‎conducted by Lueth et al (2020) showed that the highest proportion of both study groups were ‎housewives.‎ According to the percentage distribution of the women's income, three-quarters of both groups were dissatisfied with their income. This finding is ‎consistent with those of a study performed in Brazil by Velho et al (2019) who mentioned that most ‎of the participants in both groups did not have a satisfactory income.‎ Measuring the participants' BMI showed that the highest proportion of the women in both groups were overweight. This finding is supported by those of the studies conducted by Hermesch et al (2016), Addo (2010), and O'Dwyer ‎‎(2013) who reported that the highest percentage of the participants were overweight.‎ Percentage distribution of the women's smoking status showed that the majority proportion for the induced group were nonsmokers. This finding is in line with those of the ‎study conducted in Sweden by Wennerholm et al (2019) who reported that the majority of the participants ‎did not smoke. None of the spontaneous women in the present study smoked. This finding is similar to those of a previous study conducted by Attanayake et al (2018) who ‎reported similar results. However, this finding is not in line with those of the study conducted by Zanardo ‎ et al (2017) who reported that a small proportion of the spontaneous sample smoked.‎ table 2 The results of the present study showed that there was a highly significant difference between ‎the (Emergency C/S) and delivery method at p-value<0.001. Similar finding was reported in a study conducted by Jonsson et al (2013) who mentioned that C/S rate in induced labor was over twofold greater than spontaneous labor (p<0.001). However, this finding is in contrast with those of a study carried out by ‎Skeith et al (2019) who found that there was no significant difference between induction of labor and spontaneous labor in terms of the risk of C/S ‎(p-value=0.052). The results obtained from the data on post-partum blood loss revealed that ‎there was a high significance difference between post-partum blood loss and method of delivery at p-‎value<0.001. This finding is similar to those found in a previous study by Al-Turiahi et al (2016) ‎who mentioned that compared to spontaneous ‎labor, induction of labor was associated with a higher risk of post-partum blood loss (p<0.001). This finding is also supported by Khireddine et al (2013) who found compared to spontaneous labor, ‎induction of labor was associated with a higher risk of post-partum blood loss (p<0.01). ‎The results of another study conducted by Al-Zirqi et al (2009) showed that there was a highly significant ‎difference between post-partum blood loss and induction and spontaneous delivery at p-‎value<0.001. This finding is in contrast with those of a study conducted by Skeith et al (2019) who found that ‎there was no significant difference between induction of labor and spontaneous ‎labor in terms of the risk of post-partum blood loss (p-value=0.083).‎ The results of the present study also revealed a highly significant difference between the delivery methods regarding perineal laceration (p-value<0.001). This finding is consistent with ‎those of a previous study conducted by Thangarajah et al (2016) who reported that perineal laceration ‎was significantly higher in the induction of labor group (p=0.002). However, this finding disagrees with that of the ‎study conducted in Bangladesh by Ferdous and Rahman (2020) who reported that there was no ‎statistically significant difference between delivery methods regarding perineal laceration (p-value‎‎>0.05‎). In the current study, it was found that there was a highly significant deference between the induced and spontaneous groups in terms of blood transfusion needed. This finding is in disagreement with those of a study conducted by Alalem et al (2018) ‎who reported no significant differences between induced and ‎spontaneous methods regarding blood transfusion needed (p-value=0.087).‎ It was also found that there was a highly significant deference between induced and spontaneous methods in terms of uterine ‎atony (p-value<0.001). This finding is in contrast with those of the study conducted by Thangarajah et al ‎‎(2016) who found that the two groups were not significantly different regarding their uterine ‎atony.‎ The results of the present study showed a significant ‎ difference between the induced and spontaneous labor women in terms of their postpartum stay in the hospital. This finding is in agreement with the results of the ‎study by Sujata et al (2017) who reported significantly different postpartum hospital stays at the hospital following induced and spontaneous labors (p-‎value=0.0001).‎ The results of the present study demonstrated that postpartum uterotonic use, ICU admission, admission causes, hysterectomy, and pt. discharge status were similar in both groups; therefore, they were not computed. This finding is not supported by Guerra et al (2017) who reported that compared to spontaneous labor, labor induction is associated with higher rates of some maternal complications, including the need for uterotonic drugs in the postpartum, hysterectomy, admission to an intensive care unit, and longer hospital stays. According to ICU admission, which was not computed, this finding is supported by Gimovsky et al (2019) who mentioned similar findings. Conclusion In the present study, it was concluded that the majority of the induced group aged ‎‎16–23 years, graduated from primary school, lived a rural areas, were housewives, were not satisfied with their income, and were overweight, ‎while the majority of the spontaneous group aged 24–31 years, were ‎illiterate, lived in urban areas, were not satisfied with their income, and were overweight.‎ The results showed that induction of labor is associated with increased risk of cesarean ‎delivery, postpartum blood loss, uterine atony, third-degree laceration, and prolonged postpartum hospital ‎stay compared with spontaneous labor. In comparison with spontaneous labor, induced labor is associated with ‎poorer maternal and neonate outcomes.‎ Declarations Ethics approval and consent to participate The ethical approval was obtained from ethical approval committee of Nursing College/Hawler Medical University then the verbal consent has been obtained from the participants in order to interview them face to face just a questionnaire was used to ask the participant furthermore second part is check list was used for the process of delivery only observation and ticking of check list the information was obtained from participants files. Consent for publication The present manuscript does not contain any individual person’s data in any form, including any individual details, images or videos. Availability of data and materials The data were obtained from the Maternity teaching hospital /Delivery room /patients files Competing interests The authors declare that they have no competing interests Funding No external funding was obtained for the present research. Author contribution This study is Master thesis done by Bewar Husamaldin Noori and Awaz Aziz Saeed. Bewar employed in Azady Hospital /Kirkuk then she did current study as Msc degree under Hawler Medical University/Nursing College responsibility with Awaz supervision at Maternity teaching Hospital ,all thesis parts has been done by Bewar then checked and red by Awaz. CONFLICTS OF INTEREST This study has no potential conflicts of interest, whether of financial or other nature. References Prosser SJ, Barnett AG, Miller YD. Factors promoting or inhibiting normal birth. 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Prevalence of spontaneous, induced labour or planned caesarean section and factors associated with caesarean section in low-risk women in southern Brazil. Midwifery , 79 , p.102530.Available from https://openaccess.city.ac.uk/id/eprint/22700/ Hermesch AC, Allshouse AA, Heyborne KD. 2016. Body mass index and the spontaneous onset of parturition. Obstetrics & Gynecology , 128 (5), pp.1033–1038.Available from https://www.ingentaconnect.com/content/wk/aog/2016/00000128/00000005/art00019 Addo VN. 2010. Body mass index, weight gain during pregnancy and obstetric outcomes. Ghana medical journal , 44 (2).Available from https://www.ajol.info/index.php/gmj/article/view/68886 'Dwyer V, O'Kelly S, Monaghan B, Rowan A, Farah N, Turner MJ. 2013. Maternal obesity and induction of labor. Acta Obstetricia et Gynecologica Scandinavica , 92 (12), pp.1414–1418.Available from https://obgyn.onlinelibrary.wiley.com/doi/full/ 10.1111/aogs.12263 Wennerholm UB, Saltvedt S, Wessberg A, Alkmark M, Bergh C, Wendel SB et al. 2019. Induction of labour at 41 weeks versus expectant management and induction of labour at 42 weeks (SWEdish Post-term Induction Study, SWEPIS): multicentre, open label, randomised, superiority trial. bmj , 367 . Available from https://www.bmj.com/content/367/bmj.l6131 Attanayake K, Munasinghe S, Goonewardene M, Widanapathirana P, Sandeepani I, Sanjeewa L. 2018. Gestational age and birth weight centiles of singleton babies delivered normally following spontaneous labor, in Southern Sri Lanka. Ceylon Medical Journal , 63 (1), p.17. Available from https://www.researchgate.net/profile/Malik_Goonewardene/publication/324199811_Gestational_age_and_birth_weight_centiles_of_singleton_babies_delivered_normally_following_spontaneous_labor_in_Southern_Sri_Lanka/links/5b07ff86a6fdcc8c252d4ab7/Gestational-age-and-birth-weight-centiles-of-singleton-babies-delivered-normally-following-spontaneous-labor-in-Southern-Sri-Lanka.pdf Zanardo V, Bertin M, Sansone L, Felice L. 2017. The adaptive psychological changes of elective induction of labor in breastfeeding women. Early human development , 104 , pp.13–16. Available from https://www.sciencedirect.com/science/article/abs/pii/S0378378216302122 Tables Table 1 Distribution of the sociodemographic characteristics of the study sample (n= 240). Characteristics Induced labor Spontaneous labor f % f % Age 16-23 years 59 49.1 31 25.8 24-31 years 33 27.5 52 43.3 32 – 39 years 26 21.7 32 26.7 40 and more years 2 1.7 5 4.2 Total 120 100 120 100 Level of education Illiterate 28 23.3 36 30 Able to Read and Write 17 14.2 19 15.8 Primary School 32 26.6 35 29.2 Secondary School 26 21.7 20 16.7 College or Institute 17 14.2 10 8.3 Total 120 100 120 100 Residency Urban ‎35‎ ‎29.2‎ ‎52‎ ‎43.3‎ Suburban ‎31‎ ‎25.8‎ ‎27‎ ‎22.5‎ Rural ‎54‎ ‎45‎ ‎41‎ ‎34.2‎ Total 120 100 120 100 Occupation Government Employee 1 0.8 3 2.5 Student 2 1.7 0 0 Housewife 117 97.5 117 97.5 Total 120 100 120 100 Income Satisfied 28 23.3 36 30 Non-satisfied 92 76.7 84 70 Total 120 100 120 100 Distribution of the sociodemographic characteristics …… Con. Table 1 ‎ MBI Underweight 0 0 0 0 Normal Weight 14 11.7 20 16.6 Overweight 41 34.2 41 34.2 Obesity 40 33.3 38 31.7 Morbid Obesity 25 20.8 21 17.5 Total 120 100 120 100 Smoking Yes 4 3.3 0 0 No 116 96.7 120 100 Total 120 100 120 100 Secondary Smoking Yes 59 49.2 44 36.7 No 61 50.8 76 63.3 Total 120 100 120 100 Table 2 Difference between the methods of labor (induced and spontaneous labor) regarding maternal outcomes by chi square test Maternal Outcomes Induced labor Spontaneous labor chi square value p-value (Sig) f % f % Emergency C/S 16.000 <0.001 HS Yes 16 13.3 0 0 No 104 86.7 120 100 Total 120 100 120 100 Pulse beats/min. 5.857 0.021 S 70 – 80 39 32.5 57 47.5 81 – 91 43 35.8 36 30 92 – 102 38 31.7 27 22.5 Total 120 100 120 100 Temperature °C 26.734 <0.001 HS 36 – 37 43 35.8 83 69.2 37.1 38.1 77 64.2 37 30.8 Total 120 100 120 100 Blood Pressure 93.995 <0.001 HS Hypotension 37 30.8 3 2.5 Normal BP. 44 36.7 115 95.8 Hypertension 39 32.5 2 1.7 Total 120 100 0 0 Difference between maternal outcomes ………cont. Table 2 Amount of blood loss after delivery 42.872 <0.001 HS < 500 ml 57 47.5 103 85.8 500 – 999 ml 39 32.5 15 12.6 1000 – 1499 ml 1 0.8 0 0 1500 – 1999 ml 10 8.3 1 0.8 2000 – 2499 ml 7 5.8 0 0 2500 – 2999 ml 6 5.1 1 0.8 3000 ml + more 0 0 0 0 Total 120 100 120 100 Blood Transfusion Needed 19.691 <0.001 HS Yes 23 19.2 2 1.7 No 97 80.8 118 98.3 Total 120 100 120 100 No. of Blood Pints 19.940 <0.001 HS No Pint ‎ 97 ‎ ‎ 80.8 ‎ ‎ 118 ‎ ‎ 98.3 ‎ ‎ 1 Pint ‎ ‎ 16 ‎ ‎ 13.3 ‎ ‎ 2 ‎ ‎ 1.7 ‎ ‎ 2 Pints ‎ ‎ 6 ‎ ‎ 5.1 ‎ ‎ 0 ‎ ‎ 0 ‎ ‎ 3 Pints ‎ ‎ 1 ‎ ‎ 0.8 ‎ ‎ 0 ‎ ‎ 0 ‎ Total 120 100 120 100 Uterine atony 19.459 <0.001 HS Yes 18 15 0 0 No 102 85 120 100 Total 120 100 120 100 Postpartum Uterotonic Use . NC Yes ‎ 120 ‎ ‎ 100 ‎ ‎ 120 ‎ ‎ 100 ‎ No ‎ 0 ‎ ‎ 0 ‎ ‎ 0 ‎ ‎ 0 ‎ Total 120 100 120 100 Difference between maternal outcomes ………cont. Table 2 Perennial Laceration 94.975 <0.001 HS 1 st Degree 21 17.5 21 17.5 2 nd Degree 17 14.3 7 5.8 3 rd Degree 31 25.8 9 7.5 4 th Degree 22 18.3 3 2.5 No Laceration 13 10.8 80 66.7 C/S 16 13.3 0 0 Total 120 100 120 100 Postpartum Stay 82.535 <0.001 HS 24 hours 20 16.7 0 0 Total 120 100 120 100 ICU Admission . NC Yes 0 0 0 0 No 120 100 120 100 Total 120 100 120 100 Causes of ICU Admission . NC No Causes 120 100 120 100 Total 120 100 120 100 Hysterectomy . NC Yes 0 0 0 0 No 120 100 120 100 Total 120 100 120 100 Pt. Discharge Status . NC Alive 120 100 120 100 Dead 0 0 0 0 Total 120 100 120 100 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2696062","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":186054359,"identity":"ded69fca-6b20-40a5-b59d-1adfa5384620","order_by":0,"name":"Awaz saeed","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAvklEQVRIiWNgGAWjYBADOQYGHhK1GJOuJbGBaC38M5Iff2D4U5e+4fjZgw8+MNjJ6TYQ0CJxI83AgIGHLXfDmbxkwxkMycZmBwhZczvBIIFBgid3w4EcM2kehgOJ2whpkb+d/uEAg4FEusH5N0RqMbidY9jAALTJ4Aaxthjef1PMwHAgwXDmjTfGhjMMiPCL3Jnjm0EhJs93PsfwwYcKOznC3gcC5j9AQgGs0oAI5XAg30CK6lEwCkbBKBhRAABxKD+Zjx2ohwAAAABJRU5ErkJggg==","orcid":"","institution":"Hawler Medical University","correspondingAuthor":true,"prefix":"","firstName":"Awaz","middleName":"","lastName":"saeed","suffix":""},{"id":186054361,"identity":"5ba607f1-6514-4918-8f9a-92c3a056cf09","order_by":1,"name":"Bewar Husamaaldin Noori","email":"","orcid":"","institution":"Hawler Medical University","correspondingAuthor":false,"prefix":"","firstName":"Bewar","middleName":"Husamaaldin","lastName":"Noori","suffix":""}],"badges":[],"createdAt":"2023-03-15 11:29:22","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2696062/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2696062/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":34888583,"identity":"26f1e043-87f3-4e16-9c9f-1f1c3b18dde4","added_by":"auto","created_at":"2023-03-27 23:29:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":390546,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2696062/v1/96f8361c-7458-46cf-96c4-549d0115e2d6.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Maternal Outcomes of Induced Versus ‎Spontaneous Labor among Admitted Women in Delivery Room at Maternity Teaching Hospital in Erbil City: A Comparative ‎Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eSpontaneous labor refers to a birth without clinical intervention and the pregnant women they do not have induction of labor, epidural anesthesia, \u0026lrm;spinal anesthesia, general anesthesia, assisted vaginal delivery (with forceps and/or ventouse), and cesarean delivery. Women will experience spontaneous labor if they do not take \u0026lrm;prostaglandins, oxytocin, artificial rupture of membrane, or balloon catheters for the purpose of labor induction (Prosser \u003cem\u003e\u0026lrm;et al\u003c/em\u003e, 2018).\u0026lrm;\u003c/p\u003e \u003cp\u003eInduction of labor is a procedure used to stimulate uterine contractions during pregnancy before labor begins on its own, and it initiates when a birth benefits the mother or the fetus and compensates for the risks of a continuing pregnancy (Wing and Sheibani, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Induction of labor often begins with cervical ripening which includes softening and loosening of the cervix in the preparation for labor and delivery (Sciscione \u003cem\u003eet al\u003c/em\u003e, 2014). Cervical ripening is defined as the precursor to the onset of labor, in which the cervix becomes soft, either naturally or as a result of physical or pharmacological interventions (Banos et al, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2015\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIndications for induction of labor include postdate (Rampersad et al, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), gestational hypertension, chorioamnionitis, premature rupture of membrane, preeclampsia, maternal conditions (e.g., chronic hypertension and diabetes mellitus), and neonate conditions (e.g., oligohydramnios and severe neonate growth restriction) (Viteri and Sibai, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Both pharmacological (prostaglandins and oxytocin) and mechanical (balloon catheters) agents are used for induction of labor (Levine, 2016). When these methods are used individually, the incidence of cesarean delivery decreases in women undergoing induction (Mizrachi et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). Oxytocin, the hormone that stimulates uterine contractions, is less effective in cervical ripening and is usually used alone to induce labor when the cervix is ​​favorable (Bishop's degree\u0026thinsp;\u0026gt;\u0026thinsp;6) or after cervical ripening by prostaglandins or mechanical methods (Penfield and Wing, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Misoprostol (prostaglandin E1 analog) is broadly used to induce labor (Viteri and Sibai, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Induction of labor brings about many potential complications for mothers and newborns, while mechanical methods are associated with the fewest number of harmful effects (Penfield and Wing, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2017\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eWomen undergoing induction of labor may be at a higher risk of cesarean section (Saccone and Berghella, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Pharmacological methods of induction of labor are associated with possible risks, such as uterine tachysystole with or without changing the neonate heart rate, uterine rupture, fetus distress, and maternal morbidity and mortality. The incidence of these adverse events is dependent on the agent used for induction, dose, and other factors (Knight et al, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Induction of the postdate has been found to be associated with an increased risk of overall C/S due to failure to progress, chorioamnionitis, labor dystocia, uterine rupture, reduced risk of developing oligohydramnios, and meconium-stained amniotic fluid. Induction of labor does not cause postpartum hemorrhage, shoulder dystocia, or meconium aspiration (Rydahl et al, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u0026lrm; Induction of labor at 39 weeks of gestation results in lower rates of cesarean delivery, maternal morbidity, newborn morbidity, stillbirths, and newborn deaths (Sinkey et al, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eInduction of labor represents the most common interventional procedure in obstetrics. It is applied in 20\u0026ndash;25% of all pregnancies in Korea (Kim et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). The prevalence of induction of labor in Finland is very low compared to other developed countries, and the rate of successful induction in Finland is slightly higher than Ethiopia but is comparable to regional rates when induction failure is very low compared to local and regional institutions. Bishop score, which is based on cervical favorability before induction, has been used to predict whether induction of labor leads to a successful vaginal delivery or not. Low cervical score has been associated with failure of induction, prolonged labor, and a high rate of cesarean deliveries (Khandelwal et al \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Bishop's score is a remarkable predictor for success of induction (Lueth et al, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). In the United States of America and the United Kingdom, about 23% of all deliveries are by induction of labor, while the counterpart figure in Latin America is 11.4% (Guerra et al \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2017\u003c/span\u003e).\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e Using a quantitative comparative design, the present study was conducted among full-term pregnant women admitted to the Maternity Teaching \u0026lrm;Hospital in Erbil city from February 2020 to February 2021 .The ethical approval has been obtained from the ethical approval committee of Hawler Medical University /Nursing college that consists of (Assistant .Prof DR. Siyamand Hasan Muhedin)(,Assistant.Prof DR..Runak Neamatulla Husin),( L.DR..Zhyan Abdulla) (,L.Salar Saidi Husin ),(L.Banaz sediq Smail) and the head of committee (Assistant Prof. Dr.Abdulqader Husin ) Then a verbal consent has been obtained from the samples after informed them about the questionnaire items, We didn\u0026rsquo;t need written consent from participants because we dealing with them by asking questions they answer after getting agreement from them this is allowed by our university, the ethical committee in nursing college(Assistant .Prof DR. Siyamand Hasan Muhedin)(,Assistant.Prof DR..Runak Neamatulla Husin),( L.DR..Zhyan Abdulla) (,L.Salar Saidi Husin ),(L.Banaz sediq Smail) and the head of committee (Assistant Prof. Dr.Abdulqader Husin ) approved that, in case of dealing with participants by drugs ,substances, herbal and some kinds of food need written consent. The guidelines outlined in the Declaration of Helsinki were followed for the participants in order to didn\u0026rsquo;t expose them to any risk. The sample size was determined by power and sample size estimation software (Version 3.0.43). \u0026lrm;For this purpose, the following data were fed into the software: The rate of vaginal delivery which was set at 83.6% and 67.6% \u0026lrm;among the spontaneous labor group and the induction \u0026lrm;group, respectively (Abisowo et al, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2017\u003c/span\u003e), the alpha error that was set at 0.05, and the beta error that was set at 20% (power 80%). \u0026lrm;Accordingly, the estimated sample size was 112 women in the spontaneous labor group and 112 women \u0026lrm;in the induced labor group. Therefore, 240 women were recruited: 120 women for the induced group and \u0026lrm;\u0026lrm;120 for the spontaneous group. \u0026lrm;The inclusion criteria were live singleton fetus, vertex presentation, gestational age after 37 gestational weeks, cases indicated to induction of labor (in induced group), and uncomplicated cases (convulsion, severe bleeding, and shock). The exclusion criteria were mal-presentation, \u0026lrm;abnormal placentation,\u0026lrm;\u0026lrm; intrauterine neonate death, gestational age less than 37 gestational weeks,\u0026lrm; women who did not have a chronic disease \u0026lrm;or any medical problems, previous cesarean section, uncooperative patient, \u0026lrm;multiple pregnancies. Required data were gathered through a proper questionnaire aimed at collecting data on the pregnant women\u0026rsquo;s socio-demographic characteristics. The questionnaire consisted of two sections. Section 1 was used to gather data on the pregnant women\u0026rsquo;s demographic characteristics, including age \u0026lrm;\u0026lrm;(classified into 16\u0026ndash;23, 24\u0026ndash;31, 32\u0026ndash;39, and \u0026gt;\u0026thinsp;40 age groups), educational level (including illiterate, able to read and write, primary \u0026lrm;school, secondary school, and college or institute), residency (including urban, suburban, and rural), occupation \u0026lrm;\u0026lrm;(including government employee, private employee, self-employment, student, and housewife), income, smoking, and secondary smoker. \u0026lrm;Section 2 was utilized to collect data on anthropometric measurement, BMI according to the World Health Organization (WHO, 2011) (BMI was classified as follows: Underweight\u0026thinsp;\u0026lt;\u0026thinsp;18.5 kg/m\u0026sup2;, Normal weight 18.5\u0026ndash;24.9 kg/m\u0026sup2;, Overweight 25.0-29.9 kg/m\u0026sup2;, Moderate obesity (class I) 30.0\u0026ndash;34.9 kg/m\u0026sup2;, Severe (gross) obesity (class II) 35.0\u0026ndash;39.9 kg/m\u0026sup2;, and Very severe (morbid) obesity (class III)\u0026thinsp;\u0026ge;\u0026thinsp;40 kg/m\u0026sup2;), and maternal outcomes (including emergency cesarean section delivery, blood loss\u0026lrm;, need for blood transfusion, uterine atony, need for uterotonics after delivery, perennial laceration, postpartum stay in hospital, admission to ICU, hysterectomy, and status at \u0026lrm;discharge).\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eTable 1 shows the demographic data obtained from the study participants with induced and spontaneous\u0026nbsp;\u0026lrm;labor. As indicated, about half of the induced group (49.1%) aged between 16 and 23\u0026nbsp;\u0026lrm;years, and (43.3%) of the spontaneous group aged between 24 and 31 years.\u0026nbsp;\u0026lrm;Regarding the educational level, (26.6%) of the women in the induced group were primary school graduated, and (30%) in the spontaneous group were illiterate. Most of the women in the induced group (45%) lived in rural areas, and (43.3%) in the spontaneous group\u0026nbsp;\u0026lrm;lived in urban areas.\u0026lrm;\u0026lrm;\u0026nbsp;Regarding their occupation, most of the women in both\u0026nbsp;\u0026lrm;study groups (97.5%) were housewives. The results revealed that (76.7%) women in the induced group and (70%) in the spontaneous group were not satisfied with their income. Regarding their BMI, (34.2%) of the women in the induced and spontaneous groups were\u0026nbsp;\u0026lrm;overweight. In terms of their smoking status, non-smokers made up the majority proportion (96.7%) of the induced women and (100%) of the spontaneous women; however, (50.8%) of the women in the induced group and (63.3%) in the spontaneous group were secondary smokers.\u0026lrm;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 2 shows the differences between maternal outcomes regarding methods of labor (induced and \u0026lrm;spontaneous labor).\u0026lrm;There were significance to highly significance difference between the \u0026lrm;scores of the items of the maternal outcomes (Emergency C/S, vital sings, Amount of blood loss after delivery, Blood Transfusion Needed, number of Blood Pints, Uterine atony , Perennial Laceration, Postpartum Stay) with regards to the method of delivery \u0026lrm;\u0026lrm;(induced and spontaneous labor) except the items; (postpartum uterotonic use, ICU admission, admission \u0026lrm;causes, hysterectomy, and pt. discharge status) which they were not computed \u0026lrm;because similar answer in both groups.\u003c/p\u003e"},{"header":"Discusion","content":"\u003cp\u003eTable 1 Analyzing the data on the women\u0026apos;s demographic variables revealed that nearly half of the women in the induced group aged 16\u0026ndash;23 years, while the majority of the women in the spontaneous group aged 24\u0026ndash;\u0026lrm;\u0026lrm;31 years. These results are consistent with the study conducted in Italy by Poma \u003cem\u003eet al\u003c/em\u003e (2017)\u0026nbsp;\u0026lrm;who reported the majority of the participants in the induced group were within the age group of 16\u0026ndash;23 years and 24\u0026ndash;31 years in the spontaneous group.\u0026lrm;\u003c/p\u003e\n\u003cp\u003ePercentage distribution of the women\u0026apos;s level of education revealed that the\u0026nbsp;\u0026lrm;majority of the induced group were primary school graduates. This finding is inconsistent with\u0026nbsp;\u0026lrm;the results of the previous study carried out in Nigeria by Lawani \u003cem\u003eet al\u003c/em\u003e (2014) who reported that the majority of\u0026nbsp;\u0026lrm;the induced group were tertiary graduates. The present study showed that the majority of the women in the spontaneous\u0026nbsp;\u0026lrm;group were illiterate. This finding is line with that of the study conducted by Tarimo \u003cem\u003eet al\u003c/em\u003e (2020) who\u0026nbsp;\u0026lrm;reported similar results.\u0026lrm;\u003c/p\u003e\n\u003cp\u003eAccording to the data on the women\u0026apos;s residency, a large proportion of the induced women lived in rural areas. This finding disagrees with those of a descriptive observational study which was conducted in Sulaymaniyah City,\u0026nbsp;\u0026lrm;Iraq by Mohammed (2020) who reported that the majority of the induced group lived in urban areas. It also disagrees with the results of a study carried out in Ethiopia which indicated that the majority of the induced group lived in\u0026nbsp;\u0026lrm;urban areas (Lueth \u003cem\u003eet al\u003c/em\u003e 2020). However, a large proportion of the women in spontaneous group lived in urban areas. This finding is in disagreement with those of the study conducted in Spain by Marco-Gracia (2019) who found that the highest proportion of the women resided rural areas.\u003c/p\u003e\n\u003cp\u003eConcerning the participants\u0026apos; occupation, the results of the current study indicated that\u0026nbsp;\u0026lrm;the highest proportion of both study groups were housewives. This finding is persistent with those of an earlier\u0026nbsp;\u0026lrm;study conducted by Yisma \u003cem\u003eet al\u003c/em\u003e (2020) who demonstrated similar results. Similarly, the results of another study\u0026nbsp;\u0026lrm;conducted by Lueth \u003cem\u003eet al\u003c/em\u003e (2020) showed that the highest proportion of both study groups were\u0026nbsp;\u0026lrm;housewives.\u0026lrm;\u003c/p\u003e\n\u003cp\u003eAccording to the percentage distribution of the women\u0026apos;s income, three-quarters of both groups were dissatisfied with their income. This finding is\u0026nbsp;\u0026lrm;consistent with those of a study performed in Brazil by Velho \u003cem\u003eet al\u003c/em\u003e (2019) who mentioned that most\u0026nbsp;\u0026lrm;of the participants in both groups did not have a satisfactory income.\u0026lrm;\u003c/p\u003e\n\u003cp\u003eMeasuring the participants\u0026apos; BMI showed that the highest proportion of the women in both groups were overweight. This finding is supported by those of the studies conducted by Hermesch \u003cem\u003eet al\u003c/em\u003e (2016), Addo (2010), and O\u0026apos;Dwyer\u0026nbsp;\u0026lrm;\u0026lrm;(2013) who reported that the highest percentage of the participants were overweight.\u0026lrm;\u003c/p\u003e\n\u003cp\u003ePercentage distribution of the women\u0026apos;s smoking status showed that the majority proportion for the induced group were nonsmokers. This finding is in line with those of the\u0026nbsp;\u0026lrm;study conducted in Sweden by Wennerholm \u003cem\u003eet al\u003c/em\u003e (2019) who reported that the majority of the participants\u0026nbsp;\u0026lrm;did not smoke. None of the spontaneous women in the present study smoked. This finding is similar to those of a previous study conducted by Attanayake \u003cem\u003eet al\u003c/em\u003e (2018) who\u0026nbsp;\u0026lrm;reported similar results. However, this finding is not in line with those of the study conducted by Zanardo\u0026nbsp;\u0026lrm;\u003cem\u003eet al\u003c/em\u003e (2017) who reported that a small proportion of the spontaneous sample smoked.\u0026lrm;\u003c/p\u003e\n\u003cp\u003etable 2 \u0026nbsp;The results of the present study showed that there was a highly significant difference between\u0026nbsp;\u0026lrm;the (Emergency C/S) and delivery method at p-value\u0026lt;0.001. Similar finding was reported in a study conducted by Jonsson \u003cem\u003eet al\u003c/em\u003e (2013) who mentioned that C/S rate in induced labor was over twofold greater than spontaneous labor (p\u0026lt;0.001). However, this finding is in contrast with those of a study carried out by\u0026nbsp;\u0026lrm;Skeith \u003cem\u003eet al\u003c/em\u003e (2019) who found that there was no significant difference between induction of labor and spontaneous labor in terms of the risk of C/S\u0026nbsp;\u0026lrm;(p-value=0.052).\u003c/p\u003e\n\u003cp\u003eThe results obtained from the data on post-partum blood loss revealed that\u0026nbsp;\u0026lrm;there was a high significance difference between post-partum blood loss and method of delivery at p-\u0026lrm;value\u0026lt;0.001. This finding is similar to those found in a previous study by Al-Turiahi \u003cem\u003eet al\u003c/em\u003e (2016)\u0026nbsp;\u0026lrm;who mentioned that compared to spontaneous\u0026nbsp;\u0026lrm;labor, induction of labor was associated with a higher risk of post-partum blood loss (p\u0026lt;0.001). This finding is also supported by Khireddine \u003cem\u003eet al\u003c/em\u003e (2013) who found compared to spontaneous labor,\u0026nbsp;\u0026lrm;induction of labor was associated with a higher risk of post-partum blood loss (p\u0026lt;0.01).\u0026nbsp;\u0026lrm;The results of another study conducted by Al-Zirqi \u003cem\u003eet al\u003c/em\u003e (2009) showed that there was a highly significant\u0026nbsp;\u0026lrm;difference between post-partum blood loss and induction and spontaneous delivery at p-\u0026lrm;value\u0026lt;0.001. This finding is in contrast with those of a study conducted by Skeith \u003cem\u003eet al\u003c/em\u003e (2019) who found that\u0026nbsp;\u0026lrm;there was no significant difference between induction of labor and spontaneous\u0026nbsp;\u0026lrm;labor in terms of the risk of post-partum blood loss (p-value=0.083).\u0026lrm;\u003c/p\u003e\n\u003cp\u003eThe results of the present study also revealed a highly significant difference between the delivery methods regarding perineal laceration (p-value\u0026lt;0.001). This finding is consistent with\u0026nbsp;\u0026lrm;those of a previous study conducted by Thangarajah \u003cem\u003eet al\u003c/em\u003e (2016) who reported that perineal laceration\u0026nbsp;\u0026lrm;was significantly higher in the induction of labor group (p=0.002). However, this finding disagrees with that of the\u0026nbsp;\u0026lrm;study conducted in Bangladesh by Ferdous and Rahman (2020) who reported that there was no\u0026nbsp;\u0026lrm;statistically significant difference between delivery methods regarding perineal laceration (p-value\u0026lrm;\u0026lrm;\u0026gt;0.05\u0026lrm;).\u003c/p\u003e\n\u003cp\u003eIn the current study, it was found that there was a highly significant deference between the induced and spontaneous groups in terms of blood transfusion needed. This finding is in disagreement with those of a study conducted by Alalem \u003cem\u003eet al\u003c/em\u003e (2018)\u0026nbsp;\u0026lrm;who reported no significant differences between induced and\u0026nbsp;\u0026lrm;spontaneous methods regarding blood transfusion needed (p-value=0.087).\u0026lrm;\u003c/p\u003e\n\u003cp\u003eIt was also found that there was a highly significant deference between induced and spontaneous methods in terms of uterine\u0026nbsp;\u0026lrm;atony (p-value\u0026lt;0.001). This finding is in contrast with those of the study conducted by Thangarajah \u003cem\u003eet al\u003c/em\u003e \u0026lrm;\u0026lrm;(2016) who found that the two groups were not significantly different regarding their uterine\u0026nbsp;\u0026lrm;atony.\u0026lrm;\u003c/p\u003e\n\u003cp\u003eThe results of the present study showed a significant\u0026nbsp;\u0026lrm;\u0026nbsp;difference between the induced and spontaneous labor women in terms of their postpartum stay in the hospital. This finding is in agreement with the results of the\u0026nbsp;\u0026lrm;study by Sujata \u003cem\u003eet al\u003c/em\u003e (2017) who reported significantly different postpartum hospital stays at the hospital following induced and spontaneous labors (p-\u0026lrm;value=0.0001).\u0026lrm;\u003c/p\u003e\n\u003cp\u003eThe results of the present study demonstrated that postpartum uterotonic use, ICU admission, admission causes, hysterectomy, and pt. discharge status were similar in both groups; therefore, they were not computed. \u0026nbsp;This finding is not supported by\u0026nbsp;Guerra \u003cem\u003eet al\u003c/em\u003e (2017) who reported\u0026nbsp;that compared to spontaneous labor, labor induction is associated with higher rates of some maternal complications, including the need for uterotonic drugs in the postpartum, hysterectomy, admission to an intensive care unit, and longer hospital stays.\u0026nbsp;According to ICU admission, which was not computed, this finding is supported by\u0026nbsp;Gimovsky \u003cem\u003eet al\u003c/em\u003e (2019) who mentioned similar findings.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn the present study, it was concluded that the majority of the induced group aged \u0026lrm;\u0026lrm;16\u0026ndash;23 years, graduated from primary school, lived a rural areas, were housewives, were not satisfied with their income, and were overweight, \u0026lrm;while the majority of the spontaneous group aged 24\u0026ndash;31 years, were \u0026lrm;illiterate, lived in urban areas, were not satisfied with their income, and were overweight.\u0026lrm; The results showed that induction of labor is associated with increased risk of cesarean \u0026lrm;delivery, postpartum blood loss, uterine atony, third-degree laceration, and prolonged postpartum hospital \u0026lrm;stay compared with spontaneous labor. In comparison with spontaneous labor, induced labor is associated with \u0026lrm;poorer maternal and neonate outcomes.\u0026lrm;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate\u003c/p\u003e\n\u003cp\u003eThe ethical approval was obtained from ethical approval committee of Nursing College/Hawler Medical University then the verbal consent has been obtained from the participants in order to interview them face to face just a questionnaire was used to ask the participant furthermore second part is check list was used for the process of delivery only observation and ticking of check list the information was obtained from participants files.\u003c/p\u003e\n\u003cp\u003eConsent for publication\u003c/p\u003e\n\u003cp\u003eThe present manuscript does not contain any individual person\u0026rsquo;s data in any form, including any individual details, images or videos.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials\u003c/p\u003e\n\u003cp\u003eThe data were obtained from the Maternity teaching hospital /Delivery room /patients files\u003c/p\u003e\n\u003cp\u003eCompeting interests\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eNo external funding was obtained for the present research.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAuthor contribution\u003c/p\u003e\n\u003cp\u003eThis study is Master thesis done by Bewar Husamaldin Noori and Awaz Aziz Saeed. Bewar employed in Azady Hospital /Kirkuk then she did current study as Msc degree under Hawler Medical University/Nursing College responsibility with Awaz supervision at Maternity teaching Hospital ,all thesis parts has been done by Bewar then checked and red by Awaz. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONFLICTS OF INTEREST\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study has no potential conflicts of interest, whether of financial or other nature.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eProsser SJ, Barnett AG, Miller YD. Factors promoting or inhibiting normal birth. 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Available from \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.sciencedirect.com/science/article/abs/pii/S0378378216302122\u003c/span\u003e\u003cspan address=\"https://www.sciencedirect.com/science/article/abs/pii/S0378378216302122\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1 Distribution of the sociodemographic characteristics of the study sample (n= 240).\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"528\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" width=\"38.1404174573055%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"29.98102466793169%\"\u003e\n \u003cp\u003e\u003cstrong\u003eInduced labor\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"31.87855787476281%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSpontaneous labor\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.699386503067483%\"\u003e\n \u003cp\u003e\u003cstrong\u003ef\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.766871165644172%\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.766871165644172%\"\u003e\n \u003cp\u003e\u003cstrong\u003ef\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.766871165644172%\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" width=\"100%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.1404174573055%\"\u003e\n \u003cp\u003e16-23 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041745730550284%\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e49.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e25.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.1404174573055%\"\u003e\n \u003cp\u003e24-31 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041745730550284%\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e27.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e43.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.1404174573055%\"\u003e\n \u003cp\u003e32 \u0026ndash; 39 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041745730550284%\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e21.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e26.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.1404174573055%\"\u003e\n \u003cp\u003e40 and more years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041745730550284%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e4.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.1404174573055%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041745730550284%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" width=\"100%\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel of education\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.1404174573055%\"\u003e\n \u003cp\u003eIlliterate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041745730550284%\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e23.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.1404174573055%\"\u003e\n \u003cp\u003eAble to Read and Write\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041745730550284%\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e14.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e15.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.1404174573055%\"\u003e\n \u003cp\u003ePrimary School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041745730550284%\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e26.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e29.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.1404174573055%\"\u003e\n \u003cp\u003eSecondary School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041745730550284%\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e21.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e16.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.1404174573055%\"\u003e\n \u003cp\u003eCollege or Institute\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041745730550284%\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e14.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e8.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.1404174573055%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041745730550284%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.939278937381404%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.939278937381404%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" width=\"100%\"\u003e\n \u003cp\u003e\u003cstrong\u003eResidency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"38.1404174573055%\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.041745730550284%\"\u003e\n \u003cp\u003e\u0026lrm;35\u0026lrm;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.939278937381404%\"\u003e\n \u003cp\u003e\u0026lrm;29.2\u0026lrm;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.939278937381404%\"\u003e\n \u003cp\u003e\u0026lrm;52\u0026lrm;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.939278937381404%\"\u003e\n \u003cp\u003e\u0026lrm;43.3\u0026lrm;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"38.1404174573055%\"\u003e\n \u003cp\u003eSuburban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.041745730550284%\"\u003e\n \u003cp\u003e\u0026lrm;31\u0026lrm;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.939278937381404%\"\u003e\n \u003cp\u003e\u0026lrm;25.8\u0026lrm;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.939278937381404%\"\u003e\n \u003cp\u003e\u0026lrm;27\u0026lrm;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.939278937381404%\"\u003e\n \u003cp\u003e\u0026lrm;22.5\u0026lrm;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"38.1404174573055%\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.041745730550284%\"\u003e\n \u003cp\u003e\u0026lrm;54\u0026lrm;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.939278937381404%\"\u003e\n \u003cp\u003e\u0026lrm;45\u0026lrm;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.939278937381404%\"\u003e\n \u003cp\u003e\u0026lrm;41\u0026lrm;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.939278937381404%\"\u003e\n \u003cp\u003e\u0026lrm;34.2\u0026lrm;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.1404174573055%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041745730550284%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.939278937381404%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.939278937381404%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" width=\"100%\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.1404174573055%\"\u003e\n \u003cp\u003eGovernment Employee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041745730550284%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.1404174573055%\"\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041745730550284%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.1404174573055%\"\u003e\n \u003cp\u003eHousewife\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041745730550284%\"\u003e\n \u003cp\u003e117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e97.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e97.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.1404174573055%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041745730550284%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.939278937381404%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.939278937381404%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" width=\"100%\"\u003e\n \u003cp\u003e\u003cstrong\u003eIncome\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.1404174573055%\"\u003e\n \u003cp\u003eSatisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041745730550284%\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e23.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.1404174573055%\"\u003e\n \u003cp\u003eNon-satisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041745730550284%\"\u003e\n \u003cp\u003e92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e76.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.1404174573055%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.041745730550284%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.939278937381404%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.939278937381404%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.939278937381404%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eDistribution of the sociodemographic characteristics \u0026hellip;\u0026hellip; Con. Table 1\u003c/strong\u003e\u003cstrong\u003e\u0026lrm;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"486\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" width=\"100%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMBI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.78350515463917%\"\u003e\n \u003cp\u003eUnderweight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.257731958762887%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.78350515463917%\"\u003e\n \u003cp\u003eNormal Weight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.257731958762887%\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e11.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e16.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.78350515463917%\"\u003e\n \u003cp\u003eOverweight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.257731958762887%\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e34.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e34.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.78350515463917%\"\u003e\n \u003cp\u003eObesity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.257731958762887%\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e33.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e31.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.78350515463917%\"\u003e\n \u003cp\u003eMorbid Obesity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.257731958762887%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e20.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e17.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.78350515463917%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.257731958762887%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.31958762886598%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.31958762886598%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" width=\"100%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSmoking\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.78350515463917%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.257731958762887%\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e3.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.78350515463917%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.257731958762887%\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e96.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.78350515463917%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.257731958762887%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.31958762886598%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.31958762886598%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" width=\"100%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSecondary Smoking\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.78350515463917%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.257731958762887%\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e49.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e36.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.78350515463917%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.257731958762887%\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e50.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e63.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.78350515463917%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.257731958762887%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.31958762886598%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.31958762886598%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.31958762886598%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2 Difference between the methods of labor (induced and spontaneous labor) regarding maternal outcomes by chi square test\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"548\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" width=\"25.59414990859232%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMaternal Outcomes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" width=\"21.389396709323584%\"\u003e\n \u003cp\u003e\u003cstrong\u003eInduced labor\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" width=\"29.250457038391225%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSpontaneous labor\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"10.603290676416819%\"\u003e\n \u003cp\u003e\u003cstrong\u003echi square value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"13.162705667276052%\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(Sig)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.660649819494584%\"\u003e\n \u003cp\u003e\u003cstrong\u003ef\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"20.577617328519857%\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"28.880866425992778%\"\u003e\n \u003cp\u003e\u003cstrong\u003ef\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"28.880866425992778%\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" width=\"76.27737226277372%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEmergency C/S\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"10.583941605839415%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e16.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"13.138686131386862%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026lt;0.001 HS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"15.107913669064748%\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"13.189448441247002%\"\u003e\n \u003cp\u003e13.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94484412470024%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"19.18465227817746%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"15.107913669064748%\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"13.189448441247002%\"\u003e\n \u003cp\u003e86.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94484412470024%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"19.18465227817746%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"15.107913669064748%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"13.189448441247002%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.94484412470024%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"19.18465227817746%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" width=\"76.27737226277372%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePulse beats/min.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" width=\"10.583941605839415%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e5.857\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" width=\"13.138686131386862%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.021\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003e70 \u0026ndash; 80\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"15.107913669064748%\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"13.189448441247002%\"\u003e\n \u003cp\u003e32.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94484412470024%\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"19.18465227817746%\"\u003e\n \u003cp\u003e47.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003e81 \u0026ndash; 91\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"15.107913669064748%\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"13.189448441247002%\"\u003e\n \u003cp\u003e35.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94484412470024%\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"19.18465227817746%\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003e92 \u0026ndash; 102\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"15.107913669064748%\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"13.189448441247002%\"\u003e\n \u003cp\u003e31.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94484412470024%\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"19.18465227817746%\"\u003e\n \u003cp\u003e22.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"15.107913669064748%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"13.189448441247002%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94484412470024%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"19.18465227817746%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" width=\"76.27737226277372%\"\u003e\n \u003cp\u003eTemperature \u0026deg;C\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"10.583941605839415%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e26.734\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"13.138686131386862%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026lt;0.001 HS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003e36 \u0026ndash; 37\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"15.107913669064748%\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"13.189448441247002%\"\u003e\n \u003cp\u003e35.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"19.18465227817746%\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94484412470024%\"\u003e\n \u003cp\u003e69.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003e37.1 38.1\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"15.107913669064748%\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"13.189448441247002%\"\u003e\n \u003cp\u003e64.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"19.18465227817746%\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94484412470024%\"\u003e\n \u003cp\u003e30.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"15.107913669064748%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"13.189448441247002%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"19.18465227817746%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.94484412470024%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" width=\"76.27737226277372%\"\u003e\n \u003cp\u003e\u003cstrong\u003eBlood Pressure\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" width=\"10.583941605839415%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e93.995\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" width=\"13.138686131386862%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026lt;0.001 HS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003eHypotension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"15.107913669064748%\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"13.189448441247002%\"\u003e\n \u003cp\u003e30.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"19.18465227817746%\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94484412470024%\"\u003e\n \u003cp\u003e2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003eNormal BP.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"15.107913669064748%\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"13.189448441247002%\"\u003e\n \u003cp\u003e36.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"19.18465227817746%\"\u003e\n \u003cp\u003e115\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94484412470024%\"\u003e\n \u003cp\u003e95.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"15.107913669064748%\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"13.189448441247002%\"\u003e\n \u003cp\u003e32.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"19.18465227817746%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94484412470024%\"\u003e\n \u003cp\u003e1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"15.107913669064748%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"13.189448441247002%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"19.18465227817746%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.94484412470024%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.454545454545453%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.909090909090908%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"0.5454545454545454%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.818181818181818%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"0.36363636363636365%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"14.181818181818182%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"0.18181818181818182%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"14.363636363636363%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.090909090909092%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.090909090909092%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eDifference between\u003c/strong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003cstrong\u003ematernal outcomes \u0026hellip;\u0026hellip;\u0026hellip;cont. Table 2\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"548\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" width=\"76.27737226277372%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAmount of blood loss after delivery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"9\" valign=\"top\" width=\"10.583941605839415%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e42.872\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"9\" valign=\"top\" width=\"13.138686131386862%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026lt;0.001 HS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003e\u0026lt; 500 ml\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.107913669064748%\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.189448441247002%\"\u003e\n \u003cp\u003e47.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.18465227817746%\"\u003e\n \u003cp\u003e103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94484412470024%\"\u003e\n \u003cp\u003e85.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003e500 \u0026ndash; 999 ml\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.107913669064748%\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.189448441247002%\"\u003e\n \u003cp\u003e32.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.18465227817746%\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94484412470024%\"\u003e\n \u003cp\u003e12.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003e1000 \u0026ndash; 1499 ml\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.107913669064748%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.189448441247002%\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.18465227817746%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94484412470024%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003e1500 \u0026ndash; 1999 ml\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.107913669064748%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.189448441247002%\"\u003e\n \u003cp\u003e8.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.18465227817746%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94484412470024%\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003e2000 \u0026ndash; 2499 ml\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.107913669064748%\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.189448441247002%\"\u003e\n \u003cp\u003e5.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.18465227817746%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94484412470024%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003e2500 \u0026ndash; 2999 ml\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.107913669064748%\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.189448441247002%\"\u003e\n \u003cp\u003e5.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.18465227817746%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94484412470024%\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003e3000 ml + more\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.107913669064748%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.189448441247002%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.18465227817746%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94484412470024%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.107913669064748%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.189448441247002%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.18465227817746%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.94484412470024%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" width=\"76.27737226277372%\"\u003e\n \u003cp\u003e\u003cstrong\u003eBlood Transfusion Needed\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"10.583941605839415%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e19.691\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"13.138686131386862%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026lt;0.001 HS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.107913669064748%\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.189448441247002%\"\u003e\n \u003cp\u003e19.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.18465227817746%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94484412470024%\"\u003e\n \u003cp\u003e1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.107913669064748%\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.189448441247002%\"\u003e\n \u003cp\u003e80.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.18465227817746%\"\u003e\n \u003cp\u003e118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94484412470024%\"\u003e\n \u003cp\u003e98.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.107913669064748%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.189448441247002%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.18465227817746%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.94484412470024%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" width=\"76.27737226277372%\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo. of Blood Pints\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" width=\"10.583941605839415%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e19.940\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" width=\"13.138686131386862%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026lt;0.001 HS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.57314148681055%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003eNo Pint\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.107913669064748%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e97\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.189448441247002%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e80.8\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.18465227817746%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e118\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.94484412470024%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e98.3\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.57314148681055%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e1 Pint\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.107913669064748%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e16\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.189448441247002%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e13.3\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.18465227817746%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e2\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.94484412470024%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e1.7\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.57314148681055%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e2 Pints\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.107913669064748%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e6\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.189448441247002%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e5.1\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.18465227817746%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e0\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.94484412470024%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e0\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.57314148681055%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e3 Pints\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.107913669064748%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e1\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.189448441247002%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e0.8\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.18465227817746%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e0\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.94484412470024%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e0\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.107913669064748%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.189448441247002%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.18465227817746%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.94484412470024%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" width=\"76.27737226277372%\"\u003e\n \u003cp\u003e\u003cstrong\u003eUterine atony\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"10.583941605839415%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e19.459\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"13.138686131386862%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026lt;0.001 HS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.107913669064748%\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.189448441247002%\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.18465227817746%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94484412470024%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.107913669064748%\"\u003e\n \u003cp\u003e102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.189448441247002%\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.18465227817746%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.94484412470024%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.107913669064748%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.189448441247002%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.18465227817746%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.94484412470024%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" width=\"76.27737226277372%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostpartum Uterotonic Use\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"10.583941605839415%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"13.138686131386862%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.57314148681055%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003eYes\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.107913669064748%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e120\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.189448441247002%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e100\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.18465227817746%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e120\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.94484412470024%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e100\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.57314148681055%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.107913669064748%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e0\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.189448441247002%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e0\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.18465227817746%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e0\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.94484412470024%\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e0\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026lrm;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.57314148681055%\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.107913669064748%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.189448441247002%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.18465227817746%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.94484412470024%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eDifference between\u003c/strong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003cstrong\u003ematernal outcomes \u0026hellip;\u0026hellip;\u0026hellip;cont. Table 2\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"548\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" width=\"74.45255474452554%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePerennial Laceration\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"8\" valign=\"top\" width=\"12.408759124087592%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e94.975\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"8\" valign=\"top\" width=\"13.138686131386862%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026lt;0.001 HS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003e1\u003csup\u003est\u003c/sup\u003e Degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e17.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e17.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003e2\u003csup\u003end\u003c/sup\u003e Degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e14.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e5.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003e3\u003csup\u003erd\u003c/sup\u003e Degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e25.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e7.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003e4\u003csup\u003eth\u003c/sup\u003e Degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e18.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003eNo Laceration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e10.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e66.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003eC/S\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e13.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.953316953316953%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.953316953316953%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" width=\"74.45255474452554%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostpartum Stay\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" width=\"12.408759124087592%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e82.535\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" width=\"13.138686131386862%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026lt;0.001 HS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003e\u0026lt; 12 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e45.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e98.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003e12 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e16.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003e24 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e20.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003e\u0026gt; 24 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e16.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.953316953316953%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.953316953316953%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" width=\"74.45255474452554%\"\u003e\n \u003cp\u003e\u003cstrong\u003eICU Admission\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"12.408759124087592%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"13.138686131386862%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.953316953316953%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.953316953316953%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" width=\"74.45255474452554%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCauses of ICU Admission\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" width=\"12.408759124087592%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" width=\"13.138686131386862%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003eNo Causes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.953316953316953%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.953316953316953%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" width=\"74.45255474452554%\"\u003e\n \u003cp\u003e\u003cstrong\u003eHysterectomy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"12.408759124087592%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"13.138686131386862%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.953316953316953%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.953316953316953%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" width=\"74.45255474452554%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePt. Discharge Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"12.408759124087592%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"13.138686131386862%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003eAlive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003eDead\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.953316953316953%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.3980343980344%\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.47911547911548%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.216216216216218%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.953316953316953%\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.953316953316953%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"induction of labor, spontaneous labor, outcome","lastPublishedDoi":"10.21203/rs.3.rs-2696062/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2696062/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground and objectives\u003c/strong\u003e: Induction of labor refers to the stimulation of contractions ‎before the labor starts spontaneously, with or without ruptured membranes. The aim of the present study was to compare the ‎maternal outcomes of induced versus spontaneous labor.‎\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: A comparative study was conducted in Maternity Teaching Hospital in Erbil ‎city from ‎February 2020 to February 2021. Using purposive (non-probability) ‎sampling techniques, ‎‎240 pregnant women (120 with induced labor and 120 with spontaneous ‎labor) were recruited into the study. Through direct interviews, a proper researcher-designed questionnaire ‎was ‎utilized to collect required data. ‎The collected data were ‎analyzed using descriptive and inferential statistical approaches.‎\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: There were significant to ‎highly significant differences between the two delivery methods in terms of maternal outcomes, ‎emergency cesarean section, postpartum blood loss, need for blood ‎transfusion, uterine ‎atony, perennial laceration, and postpartum hospital stay.‎\u003c/p\u003e\n\u003cp\u003e‎\u003cstrong\u003eConclusions\u003c/strong\u003e: There were the significance to highly significance difference of the ‎maternal ‎outcomes between induced and spontaneous labor.\u003c/p\u003e","manuscriptTitle":"Maternal Outcomes of Induced Versus ‎Spontaneous Labor among Admitted Women in Delivery Room at Maternity Teaching Hospital in Erbil City: A Comparative ‎Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-03-27 12:43:21","doi":"10.21203/rs.3.rs-2696062/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b729225f-1d0c-4bb6-ad64-425e84663b1e","owner":[],"postedDate":"March 27th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2023-03-27T23:29:15+00:00","versionOfRecord":[],"versionCreatedAt":"2023-03-27 12:43:21","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-2696062","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2696062","identity":"rs-2696062","version":["v1"]},"buildId":"J0_U0BvcaRcwD8yVFaRlm","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}