Intrapartum monitoring tools: a comparative analysis of WHO labour care guide versus the modified partograph in low-risk laboring women

Ambica Bishnoi; Parneet Kaur; Sangeeta Rani; Satinder Pal Kaur; Gunjanpreet Kaur

doi:10.18203/2320-1770.ijrcog20263046

Authors

Ambica Bishnoi Department of Obstetrics and Gynecology, Govt. Medical College and Rajindra Hospital, Patiala, Punjab, India
Parneet Kaur Department of Obstetrics and Gynecology, Govt. Medical College and Rajindra Hospital, Patiala, Punjab, India
Sangeeta Rani Department of Obstetrics and Gynecology, Govt. Medical College and Rajindra Hospital, Patiala, Punjab, India
Satinder Pal Kaur Department of Obstetrics and Gynecology, Govt. Medical College and Rajindra Hospital, Patiala, Punjab, India
Gunjanpreet Kaur Department of Obstetrics and Gynecology, Govt. Medical College and Rajindra Hospital, Patiala, Punjab, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20263046

Keywords:

Active stage of labour, Labour care guide, Partograph

Abstract

Background: Traditionally partograph has been used to monitor labour. WHO introduced Labour Care Guide in 2020. The present study was undertaken to compare labour outcomes using the WHO Labour Care Guide (LCG) and the modified WHO partograph. This study aimed to study the WHO LCG and modified partograph in low-risk labouring women.

Methods: The study was a hospital based cross sectional randomised study done in the Department of Obstetrics and Gynaecology, from 2023 to 2024. 200 low risk labouring women divided into two groups. Group A was monitored using the Labour Care Guide (LCG), whereas Group B was assessed using the WHO modified partograph.

Results: The mean duration of active stage of labour was 121.90±44.91 min in Group A and 210.10±45.75 min in Group B. This was the most important observation in the study (p-value <0.001). Oxytocin was used in 10% of subjects in Group A and 37% in Group B. This difference was highly significant (p value <0.001). The caesarean section rate was more in Group B (21% vs 7%) as compared to Group A.

Conclusions: The study concluded that the WHO LCG is a safe, effective, and patient-centred alternative to the Modified WHO Partograph for labour monitoring. Its use was associated with a shorter active phase of labour, reduced need for oxytocin augmentation, and lower caesarean section rates without adversely affecting maternal or neonatal outcomes.

Metrics

Metrics Loading ...

References

Liao JB, Buhimschi CS, Norwitz ER. Normal labor: mechanism and duration. Obstet Gynecol Clin North Am. 2005;32(2):145-64. DOI: https://doi.org/10.1016/j.ogc.2005.01.001

Ahmed I, Ali SM, Amenga-Etego S, Ariff S, Bahl R, Baqui AH, et al. Population-based rates, timing, and causes of maternal deaths, stillbirths, and neonatal deaths in south Asia and sub-Saharan Africa: a multi-country prospective cohort study. Lancet Global Heal. 2018;6(12):e1297-308. DOI: https://doi.org/10.1016/S2214-109X(18)30385-1

Ubom AE, Nieto-Calvache AJ, Malel ZJ, Nunes I. FIGO position statement on the use of the WHO labor care guide versus the partograph. Int J Gynecol Obstet. 2025;170(1):25-27. DOI: https://doi.org/10.1002/ijgo.70151

Sarsam SD, Flayeh RM, Alnakkash UM. Implication of the two who partographs, (composite and simplified) regarding maternal and neonatal outcome. Int J Sci Res Knowled. 2014;2(9):433. DOI: https://doi.org/10.12983/ijsrk-2014-p0433-0443

Kwast BE, Poovan P, Vera E, Kohls E. The modified WHO partograph: do we need a latent phase? British J Midwif. 2008;16(8):527-32. DOI: https://doi.org/10.12968/bjom.2008.16.8.30787

Van Bogaert LJ. The partogram. S Afr Med J. 2003;93(11):830-3. DOI: https://doi.org/10.1017/S0305862X00017775

Opoku BK, Nguah SB. Utilization of the modified WHO partograph in assessing the progress of labour in a metropolitan area in Ghana. Res J Women’s Health. 2015;2(2):1-7. DOI: https://doi.org/10.7243/2054-9865-2-2

World Health Organization. WHO recommendations: intrapartum care for a positive childbirth experience, 2018.

WHO labour care guide: user’s manual. Geneva: World Health Organization; 2020. Available at: https://www.who.int/publications/i/item/9789241550215. Accessed 01 January 2026.

Pandey D, Bharti R, Dabral A, Khanam Z. Impact of WHO Labor Care Guide on reducing cesarean sections at a tertiary center: an open-label randomized controlled trial. AJOG Glob Rep. 2022;2(3):100075. DOI: https://doi.org/10.1016/j.xagr.2022.100075

Srividya N, Lakshmi SJ. A study on implementation of WHO labour care guide in low-risk pregnant women and its impact on maternal and perinatal outcome. Int J Reprod Contracept Obstet Gynecol. 2023;12(1):226-30. DOI: https://doi.org/10.18203/2320-1770.ijrcog20223498

Vogel JP, Pujar Y, Vernekar SS, Armari E, Pingray V, Althabe F, et al. Effects of the WHO Labour Care Guide on cesarean section in India: a pragmatic, stepped-wedge, cluster-randomized pilot trial. Nature Medi. 2024;30(2):463-9. DOI: https://doi.org/10.1038/s41591-023-02751-4

Doreswamy N. New World Health Organization labour care guide in reducing intrapartum caesarean section rates at tertiary care hospital-Hassan institute of medical sciences, Hassan. Int J Reproduct Contracept Obstetr Gynecol. 2023;12(8):2399-402. DOI: https://doi.org/10.18203/2320-1770.ijrcog20232279