Labor Comfort
Conditions
Keywords
labor care guide
Brief summary
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.
Detailed description
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.
Interventions
DEVICElabor care guide
labor monitoring tool
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
15 Months to 45 Months
Healthy volunteers
Yes
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Healthcare Provider Satisfaction as Measured by the Provider Satisfaction Questionnaire (PSQ) | assessed at 6 months | Measured using a 5-point Likert scale. Range: 1-5. Higher scores indicate greater satisfaction. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mode of delivery | At delivery | The percentage of participants undergoing different modes of delivery (e.g., normal vaginal delivery, operative vaginal delivery, or cesarean section) |
| Duration of active labor | At delivery | The total duration of the active phase of labor, measured in hours. |
| Incidence of maternal complications | assessed at 6 weeks postpartum | The percentage of mothers who experience any postpartum or intrapartum complications (e.g., postpartum hemorrhage, infection). |
| Incidence of neonatal complications | At delivery | The percentage of newborns who experience neonatal complications (e.g., respiratory distress, hypoglycemia). |
| Duration of hospital stay | from birth until hospital discharge average 2 to 3 days | The total number of days the mother and/or neonate remained hospitalized from admission to discharge. |
| Neonatal Outcomes via Apgar Score and NICU Admission | from birth until hospital discharge average 2 to 3 days | 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). |
Countries
Egypt
Outcome results
None listed