Publication:

Comparative analysis of WHO labour care guide versus WHO modified partogram on labour outcomes

Background Effective intrapartum monitoring is essential for improving maternal and neonatal outcomes while minimizing unnecessary obstetric interventions. The World Health Organization (WHO) labour care guide (LCG) is an updated labour monitoring tool that emphasizes individualized assessment and respectful maternity care compared with the WHO modified partogram. This study compared labour outcomes between these two approaches.

Methods A prospective randomized controlled trial was conducted among 300 women with term singleton pregnancies in spontaneous active labour with cephalic presentation at a tertiary care centre. Participants were randomized to labour monitoring using the WHO labour care guide (n=150) or the WHO modified partogram (n=150). The primary outcome was mode of delivery. Secondary outcomes included labour characteristics, maternal complications, neonatal outcomes, and maternal satisfaction assessed using the birth satisfaction scale-revised.

Results The WHO LCG group had a significantly higher normal vaginal delivery rate than the modified partogram group (85.33% versus 68.67%; p=0.001) and a lower caesarean section rate (14.67% versus 31.33%). The active phase of labour was significantly shorter (4.56±0.99 versus 4.95±1.13 hours; p=0.002). Non-progress of labour as an indication for caesarean section was less frequent (9.09% versus 42.55%; p=0.028). Maternal complications and neonatal outcomes were comparable, whereas maternal satisfaction was significantly higher with the WHO LCG (96.00% versus 88.67%; p=0.014).

Conclusions The WHO labour care guide improved labour outcomes by increasing vaginal deliveries, reducing caesarean sections, shortening labour duration, and enhancing maternal satisfaction without compromising neonatal outcomes.