Labor Care Guide Application

Labor Care Guide Application in Ain Shams University Maternity Hospital: A Randomized Controlled Trial

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.

Inclusion Criteria:

1. Pregnant woman who will undergo vaginal delivery at Ain Shams University Maternity Hospital with gestational age above or equal 37 weeks
2. Vertex presentation .
3. Women with estimated fetal weight 2.5 till 4 kg

Exclusion Criteria::

1. Placenta previa
2. Placenta previa accreta
3. Macrosomic baby above 4 kg in diabetic women and above 4.5 kg in non diabetic women
4. Placenta abruption complicated by non reassuring CTG or life threatening bleeding
5. Cord prolapse
6. Vasa previa
7. Primary active genital herpes simplex
8. Patient with anemia which may lead to atonic uterus and prolonged labor.
9. Women with previously scarred uterus due to risk of ruptured uterus and postpartum hemorrhage