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Comparative study of induced versus spontaneous labour in women to predict materno-fetal outcomes using a modified WHO partograph

Background Labour outcomes differ significantly between induced and spontaneous onset, with implications for maternal and neonatal health. The modified WHO partograph provides an objective tool for monitoring labour progress and guiding timely intervention. This study aimed to compare induced versus spontaneous labour using the modified WHO partograph to predict maternal and foetal outcomes.

Methods A prospective randomised clinical study was conducted on 300 patients with term pregnancies at ACS Medical College, Chennai, over six months. Patients were allocated to two groups: induced labour (n=150) and spontaneous labour (n=150). Labour was monitored using the WHO modified partograph, assessing the duration of labour phases, oxytocin augmentation, progress across alert/action lines, maternal complications and neonatal outcomes, including Apgar scores, meconium-stained liquor, NICU admissions and mortality.

Results Induced labour was significantly associated with a significantly prolonged active phase (4.6 vs. 3.2 hrs, p<0.001) and second stage (38.4 vs. 30.2 min, p=0.02). Oxytocin augmentation (45.3% vs. 20.7%), alert line crossing (34.7% vs. 15.3%) and action line crossing (17.3% vs. 6.7%) were more frequent in the induced cases (p<0.05). Vaginal delivery was significantly more common in spontaneous labour (76.0% vs. 58.7%, p=0.004), whereas the caesarean delivery rate was higher in induced cases (34.0% vs. 18.7%, p=0.004). The incidence of meconium-stained liquor (12.7% vs. 6.0%, p=0.04) and NICU admissions (14.7% vs. 7.3%, p=0.03) were also significantly higher in the induced group.

Conclusions Induction of labour is associated with prolonged labour, greater intervention needs, higher caesarean rates and increased neonatal complications compared to spontaneous labour. Spontaneous labour monitored with the modified WHO partograph showed more favourable outcomes.