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
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20263031Keywords:
Fetomaternal outcome, Intrapartum care, Labour monitoring, Maternal outcome, Neonatal outcome, WHO labour care guideAbstract
-
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.
References
World Health Organization. WHO recommendations: intrapartum care for a positive childbirth experience. Geneva: World Health Organization. 2018.
World Health Organization. Monitoring childbirth in a new era for maternal health. Geneva: World Health Organization. 2020.
World Health Organization. WHO labour care guide: user’s manual. Geneva: World Health Organization. 2020.
Patabendige M, Wickramasooriya DJ, Dasanayake DLW. WHO Labor Care Guide as the next generation partogram: revolutionising the quality of care during labor. Eur J Midwifery. 2021;5:26.
Vogel JP, Comrie-Thomson L, Pingray V, Gadama L, Galadanci H, Goudar S, et al. Usability, acceptability and feasibility of the World Health Organization Labour Care Guide: a mixed-methods, multicountry evaluation. Birth. 2021;48(1):66-75.
Sharma D, Farahbakhsh N, Shastri S, Sharma P. Intrauterine growth restriction-part 2. J Matern Fetal Neonatal Med. 2016;29(24):4037-48.
Bohren MA, Bernitz S, Tunçalp Ö, Bonet M, Oladapo OT, Vogel JP, et al. Development of the WHO Labour Care Guide: an international survey of maternity care providers. BMC Pregnancy Childbirth. 2021;21:137.
Bohren MA, Tunçalp Ö, Miller S, Oladapo OT, Vogel JP, Gülmezoglu AM, et al. The WHO Labour Care Guide: next-generation intrapartum monitoring. BMJ Glob Health. 2020;5:2415.
Oladapo OT, Souza JP, Fawole B, Mugerwa K, Perdoná G, Alu FE, et al. Progression of the first stage of spontaneous labour: a prospective cohort study. PLoS Med. 2018;15(1):1002492.
Zhang J, Landy HJ, Branch DW, Burkman R, Haberman S, Gregory KD, et al. Contemporary patterns of spontaneous labor with normal neonatal outcomes. Obstet Gynecol. 2010;116(6):1281-7.
Laughon SK, Branch DW, Beaver J, Zhang J. Changes in labor patterns over 50 years. Am J Obstet Gynecol. 2012;206(5):419.
Neal JL, Lowe NK. Physiologic partograph to improve birth safety and outcomes among low-risk women. J Midwifery Women Health. 2012;57(2):134-42.
Downe S, Finlayson K, Tunçalp Ö, Gülmezoglu AM, Bonet M, Vogel JP, et al. What matters to women during childbirth: a systematic qualitative review. PLoS One. 2018;13(4):194906.
Miller S, Abalos E, Chamillard M, Ciapponi A, Colaci D, Comandé D, et al. Beyond too little, too late and too much, too soon: a pathway towards evidence-based, respectful maternity care worldwide. Lancet. 2016;388(10056):2176-92.
Lavender T, Hart A, Smyth RM. Effect of partograph use on outcomes for women in spontaneous labour at term. Cochrane Database Syst Rev. 2018;(8):5461.
World Health Organization. Standards for improving quality of maternal and newborn care in health facilities. Geneva: World Health Organization. 2016.
Downloads
Published
How to Cite
Issue
Section
