Impact of New WHO Labor Care Guide on Reducing Intrapartum Cesarean Section Rates at Tertiary Care Hospital - KDMCH, Mathura
DOI:
https://doi.org/10.71393/g0k6wm22Keywords:
Labor Care Guide, Cesarean section, Partograph, Intrapartum care, Maternal outcomesAbstract
Introduction: Global rise in cesarean section rates necessitate innovative approaches to intrapartum care. The World Health Organization introduced the Labor Care Guide (LCG) in 2020 as a next-generation partograph emphasizing respectful parturient care, evidence-based monitoring, shared decision making and with good birthing experience.
Aims & Objectives: To evaluate the effect of the WHO LCG on labor outcomes, particularly cesarean delivery rates, maternal complications, duration of hospital stay, and neonatal outcomes compared to the modified WHO partograph.
Materials & Methods: A prospective randomized controlled trial was conducted at K.D. Medical College Hospital, Mathura, including 203 antenatal women (37-40 weeks gestation) in spontaneous active labor with cephalic presentation. Women were randomly allocated to monitoring with WHO LCG (study group, n=101) and modified WHO partograph (control group, n=102). Outcomes assessed included mode of delivery, active labor duration, maternal complications, hospital stay, Apgar scores, and NICU admissions.
Results: Epidemiological characteristics including age and parity were comparable between both groups (study and control). Cesarean section rate was significantly lower in the study group (10.89%) compared to controls (32.35%) (p=0.0002), with an absolute risk reduction of 21.5%. Active labor duration was significantly shorter in the study group (p<0.0001). Mean hospital stay was reduced in the study group (3.32 vs 3.97 days, p=0.005). Neonatal outcomes including Apgar scores and NICU admissions were comparable between groups. Logistic regression showed LCG use independently reduced prolonged hospitalization odds by 52% (AOR 0.48, p=0.012).
Conclusion: Implementation of the WHO Labor Care Guide significantly reduced intrapartum cesarean section rates and shortened the hospital stay without compromising maternal or neonatal safety, supporting its adoption in tertiary care settings.
