Publication:

An observational study to evaluate feto maternal outcome in labour management using the WHO labour care guide among women admitted to labour room in a tertiary care centre of South Gujarat

Background Labour and childbirth are critical events that significantly influence maternal and neonatal outcomes. The world health organization (WHO) labour care guide (LCG) is an evidence-based, woman-centred tool designed to improve intrapartum monitoring through individualized labour assessment and timely clinical decision-making. This study evaluated fetomaternal outcomes associated with the use of the WHO Labour Care Guide in a tertiary care centre.

Methods A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, Government Medical College, New Civil Hospital, Surat, Gujarat, India, from March 2025 to March 2026. A total of 500 term pregnant women with singleton cephalic pregnancies in active labour (≥5 cm cervical dilatation) were included. Women with previous caesarean section, multiple gestation, malpresentation or high-risk pregnancies requiring immediate intervention were excluded. Labour was monitored using the WHO Labour Care Guide and maternal and neonatal outcomes were analysed.

Results Among the 500 women, 452 (90.4%) had spontaneous vaginal delivery, 10 (2.0%) required instrumental delivery and 38 (7.6%) underwent caesarean section. Maternal complications occurred in 14 (2.8%) women, with postpartum haemorrhage being the most common. Most neonates had Apgar scores ≥8 at 1 minute (97.6%) and 5 minutes (98.0%). Normal birth weight (2.5–3.5 kg) was observed in 76% of neonates, while NICU admission was required in only 2.4%. Crossing the LCG alert threshold was significantly associated with adverse maternal outcomes (p<0.001).

Conclusions The WHO Labour Care Guide is an effective tool for intrapartum monitoring and is associated with favourable maternal and neonatal outcomes, timely recognition of labour abnormalities and reduced unnecessary obstetric interventions.