IMPACT OF THE WHO LABOUR CARE GUIDE ON MATERNAL OUTCOMES IN LOW-RISK PREGNANT WOMEN: A COMPARISON WITH WHO MODIFIED PARTOGRAPH

Abstract

Background: The World Health Organization's Labour Care Guide (LCG) was introduced as a woman-centered, evidence-based tool to improve labor monitoring and reduce unnecessary interventions. Its comparative effectiveness against WHO modified partographs, commonly used in clinical practice, remains underexplored.
Objective: This study aimed to compare the effects of the WHO Labour Care Guide with a WHO modified partograph on key labor outcomes.
Methods: A prospective, comparative observational study was conducted among 100 low-risk pregnant women in spontaneous labor at a tertiary care hospital in India. Participants were allocated alternately to either the Modified Partograph group (n=50) or the WHO LCG group (n=50). Maternal and fetal outcomes were compared, with a primary focus on the incidence of prolonged first stage of labor and rates of obstetric intervention.
Results: Baseline maternal characteristics were similar between groups. A clinically important trend was observed: the incidence of prolonged first stage of labor was 6.0% (3/50) in the Modified Partograph group compared to 0% (0/50) in the WHO LCG group, though this difference was not statistically significant (p=0.119). The rate of operative vaginal delivery was lower in the LCG group (4.0% vs. 6.0%, p=0.500). Oxytocin use was less frequent in the LCG group (44.0% vs. 60.0%), but this difference was also not statistically significant (p=0.109).
Conclusion: The use of the WHO Labour Care Guide showed a strong, clinically promising trend towards the prevention of prolonged labor and reduced intervention rates compared to a Modified Partograph. While not statistically significant in this sample, the complete avoidance of prolonged labor in the LCG group suggests a potential benefit that warrants further investigation in a larger, adequately powered randomized controlled trial.