Application of the WHO Labor Care Guide in Ain Shams university Maternity hospital demonstrates high healthcare provider acceptability and improves labor progression, increases vaginal delivery rates, and reduces selected maternal complications without adversely affecting neonatal outcomes.
The Labor Care Guide (LCG) is a tool developed by the World Health Organization (WHO) to support evidence-based, woman-centered intrapartum care and improve labor monitoring. It was introduced as an alternative to the traditional partograph, aiming to facilitate timely clinical decision-making and enhance the quality of maternity care. This randomized controlled trial was conducted at Ain Shams University Maternity Hospital to evaluate the effect of the WHO Labor Care Guide on maternal and neonatal outcomes among women undergoing vaginal delivery. Eligible pregnant women were randomly assigned to one of two groups: a study group monitored using the WHO Labor Care Guide and a control group monitored using the modified WHO partograph. Participants underwent routine obstetric assessment and monitoring throughout labor according to the allocated monitoring tool. Maternal outcomes assessed included labor progression, mode of delivery, and intrapartum and postpartum complications. Neonatal outcomes included neonatal well-being, need for neonatal intensive care admission, and neonatal complications. Healthcare provider satisfaction with the labor monitoring tool was also evaluated. The study aimed to compare the effectiveness of the WHO Labor Care Guide with the modified WHO partograph in supporting labor management and improving maternal and neonatal care.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
350
labor monitoring tool
Ain Shams University Maternity Hospital
Cairo, Egypt
Healthcare Provider Satisfaction as Measured by the Provider Satisfaction Questionnaire (PSQ)
Measured using a 5-point Likert scale. Range: 1-5. Higher scores indicate greater satisfaction.
Time frame: assessed at 6 months
Mode of delivery
The percentage of participants undergoing different modes of delivery (e.g., normal vaginal delivery, operative vaginal delivery, or cesarean section)
Time frame: At delivery
Duration of active labor
The total duration of the active phase of labor, measured in hours.
Time frame: At delivery
Incidence of maternal complications
The percentage of mothers who experience any postpartum or intrapartum complications (e.g., postpartum hemorrhage, infection).
Time frame: assessed at 6 weeks postpartum
Incidence of neonatal complications
The percentage of newborns who experience neonatal complications (e.g., respiratory distress, hypoglycemia).
Time frame: At delivery
Duration of hospital stay
The total number of days the mother and/or neonate remained hospitalized from admission to discharge.
Time frame: from birth until hospital discharge average 2 to 3 days
Neonatal Outcomes via Apgar Score and NICU Admission
Neonatal well-being will be assessed using the Apgar score at 5 minutes (ranging from 0 to 10, where higher scores indicate better neonatal health) and the rate of admission to the Neonatal Intensive Care Unit (NICU).
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Time frame: from birth until hospital discharge average 2 to 3 days