Labour Care Guide Trial for reducing Caesarean Section in India

Conditions

Health Condition 1: Z139- Encounter for screening, unspecified

Vogel JP, Pujar Y, Vernekar SS, Armari E, Pingray V, Althabe F, Gibbons L, Berrueta M, Somannavar M, Ciganda A, Rodriguez R, Bendigeri S, Kumar JA, Patil SB, Karinagannanavar A, Anteen RR, Mallappa Ramachandrappa P, Shetty S, Bommanal L, Haralahalli Mallesh M, Gaddi SS, Chikkagowdra S, Raghavendra B, Homer CSE, Lavender T, Kushtagi P, Hofmeyr GJ, Derman R, Goudar S.

2024-01-3010 citations

10.1038/s41591-023-02751-4

Implementing the WHO Labour Care Guide to reduce the use of Caesarean section in four hospitals in India: protocol and statistical analysis plan for a pragmatic, stepped-wedge, cluster-randomized pilot trial

Joshua P. Vogel, Verónica Pingray, Fernando Althabe, Luz Gibbons, Mabel Berrueta et al. (29 authors)

Reproductive Health2023-01-2022 citations

10.1186/s12978-022-01525-4

Interventions

Intervention1: Co-designed implementation strategy targeting healthcare providers to improve intrapartum care: The strategy will target the use of the LCG by maternity care providers, as well as promo

Eligibility

Inclusion criteria

Inclusion criteria: Cluster: Health facility is the randomization unit. Participating clusters (formative phase and trial phase) are four public hospitals in India. Across these hospitals, the mean CS rate is =30% Healthcare providers attending childbirth will be the target of the intervention.

Exclusion criteria

Exclusion criteria: Facilities with C Section rate less than 30%

Design outcomes

Primary

Measure	Time frame
Use of CS amongst women in Robson Group 1 (i.e. women who are nulliparous, singleton, cephalic, =37 weeks’ gestation, in spontaneous labour).Timepoint: At discharge from the facility	—

Secondary

Measure	Time frame
Fetal / Neonatal outcomes 1. Antepartum stillbirth (Fetal death prior to admission) 2. Intrapartum stillbirth 3. Neonatal death (Neonatal death in a liveborn infant by day 7 or discharge, whichever came first) Timepoint: At discharge from the facility;Maternal outcomes 1. CS rate in women in Robson Groups 1 and 2 2. CS rate in women in Robson Groups 1 to 5 3. Overall CS rate 4. Augmentation with oxytocin during labour rate 5. Early artificial rupture of the membranes rate 6. Episiotomy rate 7. Operative vaginal birth rate 8. Duration of hospital admissionTimepoint: At discharge from the facility;Women’s experience outcomes 1. Woman’s experience with labour companion 2. Woman’s experience of coping with pain 3. Woman’s experience of offering oral fluids 4. Woman’s experience of mobilising during labour 5. Woman’s experience of birth position of choice 6. Woman’s experience of time health worker spent with them 7. Woman’s experience of privacy 8. Woman’s overall experience of care Timepoint: At discharge from the facility	—

Measure

Time frame

Fetal / Neonatal outcomes 1. Antepartum stillbirth (Fetal death prior to admission) 2. Intrapartum stillbirth 3. Neonatal death (Neonatal death in a liveborn infant by day 7 or discharge, whichever came first) Timepoint: At discharge from the facility;Maternal outcomes 1. CS rate in women in Robson Groups 1 and 2 2. CS rate in women in Robson Groups 1 to 5 3. Overall CS rate 4. Augmentation with oxytocin during labour rate 5. Early artificial rupture of the membranes rate 6. Episiotomy rate 7. Operative vaginal birth rate 8. Duration of hospital admissionTimepoint: At discharge from the facility;Women’s experience outcomes 1. Woman’s experience with labour companion 2. Woman’s experience of coping with pain 3. Woman’s experience of offering oral fluids 4. Woman’s experience of mobilising during labour 5. Woman’s experience of birth position of choice 6. Woman’s experience of time health worker spent with them 7. Woman’s experience of privacy 8. Woman’s overall experience of care Timepoint: At discharge from the facility

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Countries

India

Contacts

Public ContactDr Yeshita V Pujar

KLE Academy of Higher Education and Researchs J N Medical College

yvpujar@hotmail.com9448142989

Outcome results

None listed