Labour outcomes among low-risk women using WHO next-generation partograph versus WHO composite partograph: A quasi-experimental study

Document Type

Article

Department

Obstetrics and Gynaecology (East Africa)

Abstract

Background:

Partogram is an important tool in the management of labor and delivery. Its correct use, has been shown to decrease maternal and newborn adverse events including deaths. In Tanzania, composite partograph is used as a standard of care. Recently, the World Health Organization (WHO) released Labour Care Guide (LCG), a next generation partograph which emphases on woman centered care. This study aimed to compare maternal and newborn outcomes among low-risk pregnant women who were monitored by using WHO LCG versus those who were monitored by using composite partograph.

Methodology:

This Quasi Experimental Study on LCG, was conducted at Mnazi Mmoja and Vijibweni hospitals in Dar es salaam, Tanzania. The following outcomes were compared as depicted in the WHO quality of care framework: mode of delivery, Post-Partum Hemorrhage, labour augmentation, duration of labor, maternal death, APGAR, admission to Neonatal Intensive Care Unit and perinatal death. Statistical analysis was done by using Statistical Package for Social Sciences. Stepwise logistic regression was done to identify factors associated with dichotomous outcomes. Adjusted Odds Ratio, and 95% confidence interval were used to present the results.P value <0.05 was considered significant

Results:

A total of 482 women were enrolled; 241 in the intervention and 241 in the comparison group. There was no difference regarding maternal and newborn outcomes among women in the two study groups; Post-Partum Hemorrhage (p=0.69), Perineal trauma (p=0.65) and maternal death; APGAR score at 5 minutes (p=0.41), need for NICU admission (p= 0.80) and perinatal death (p=0.33). Parity of 3 and above was associated with better maternal outcome AOR= 3.05, 95%CI:1.40- 6.65; p=0.005 while augmentation of labour was associated with less chances of better maternal outcome AOR=0.33,95% CI: 0.16- 0.68: p= 0.003. Cesarean section was ssociated with less chances of better maternal outcome AOR=0.33,95% CI: 0.16- 0.68: p= 0.003. Cesarean section was associated with poor newborn outcome AOR= 0.43, 95% CI: 0.19- 0 .96; p=0.04.

Conclusion:

From this study, monitoring labour in low-risk women using WHO LCG had similar maternal and newborn outcome when compared with use of a composite partograph.Large studies powered to compare maternal and newborn outcomes including high risk pregnant women in busy labour ward are highly recommended.

Comments

This work was published after the author joined Aga Khan University.

Publication ( Name of Journal)

Research Square

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Share

COinS