Outcome of Labour in Primigravida Using WHO Labour Care Guide at Tertiary Care Hospital, Larkana
DOI:
https://doi.org/10.70749/ijbr.v3i7.2141Keywords:
Primigravida, WHO Labour Care Guide, Vaginal Delivery, Caesarean Section, Labour Monitoring, Maternal Outcome.Abstract
Introduction: Labour complications contribute to maternal and neonatal morbidity in low-resource settings. The WHO Labour Care Guide (LCG) is an evidence-based tool designed to improve labour outcomes and reduce unnecessary caesarean sections (CS) (1). Objective: To evaluate labour outcomes in primigravida women using the WHO LCG at Sheikh Zayed Woman Hospital, Larkana. Materials and Methods: This descriptive study, conducted from February, 2025 to May, 2025 at Sheikh Zayed Woman Hospital Larkana, enrolled 237 primigravida women. Labour was monitored using the WHO LCG, with data on delivery mode and maternal/fetal parameters analyzed in SPSS version 20 using chi-square tests (p≤0.05). Results: Vaginal delivery occurred in 86.9% (206/237) of cases, with 13.1% (31/237) requiring CS, primarily due to fetal distress (41%) and prolonged first stage (22%). Supportive care (92.4% with companions, 78% with pain relief) enhanced outcomes. CS rates were lower than the institutional baseline (25–30%) (19). Conclusion: The WHO LCG improved labour monitoring, reduced avoidable CS, and enhanced maternal outcomes in primigravida women.
Downloads
References
1. Pingray V, Bonet M, Berrueta M, et al. The development of the WHO Labour Care Guide: an international survey of maternity care providers. Reprod Health. 2021;18(1):66.
https://doi.org/10.1186/s12978-021-01074-2
2. Pandey D, Bharti R, Dabral A, et al. Impact of WHO Labor Care Guide on reducing cesarean sections at a tertiary center: an open-label randomized controlled trial. AJOG Glob Rep. 2022;2(3):100075.
https://doi.org/10.1016/j.xagr.2022.100075
3. Vogel JP, Pingray V, Althabe F, et al. Implementing the WHO Labour Care Guide to reduce the use of Caesarean section in four hospitals in India: a pragmatic, stepped-wedge, cluster-randomized pilot trial. Reprod Health. 2023;20(1):18.
https://doi.org/10.1186/s12978-022-01525-4
4. Patabendige M, Wickramasooriya DJ, Dasanayake DL. WHO Labor Care Guide as the next generation partogram: revolutionising the quality of care during labor. Eur J Midwifery. 2021;5:26.
https://doi.org/10.18332/ejm/138597
5. Hofmeyr GJ, Bernitz S, Bonet M, et al. WHO next‐generation partograph: revolutionary steps towards individualised labour care. BJOG. 2021;128(10):1658.
6. Khalifa E, El-Sateh A, Zeeneldin M, et al. Effect of maternal BMI on labor outcomes in primigravida pregnant women. BMC Pregnancy Childbirth. 2021;21(1):753.
https://doi.org/10.1186/s12884-021-04236-z
7. Biana CB, Cecagno D, Porto AR, et al. Non-pharmacological therapies applied in pregnancy and labor: an integrative review. Rev Esc Enferm USP. 2021;55:e03681.
https://doi.org/10.1590/s1980-220x2019019703681
8. Hong J, Atkinson J, Mitchell AR, et al. Comparison of maternal labor-related complications and neonatal outcomes following elective induction of labor at 39 weeks of gestation vs expectant management: a systematic review and meta-analysis. JAMA Netw Open. 2023;6(5):e2313162.
https://doi.org/10.1001/jamanetworkopen.2023.13162
9. Kujabi ML, Mikkelsen E, Housseine N, et al. Labor augmentation with oxytocin in low-and lower-middle-income countries: a systematic review and meta-analysis. AJOG Glob Rep. 2022;2(4):100123.
https://doi.org/10.1016/j.xagr.2022.100123
10. Bahri Khomami M, Shorakae S, Hashemi S, et al. Systematic review and meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome. Nat Commun. 2024;15(1):5591.
https://doi.org/10.1038/s41467-024-49749-1
11. Ng BK, Chuah JN, Cheah FC, et al. Maternal and fetal outcomes of pregnant women with bacterial vaginosis. Front Surg. 2023;10:1084867.
https://doi.org/10.3389/fsurg.2023.1084867
12. Alizadeh-Dibazari Z, Abdolalipour S, Mirghafourvand M. The effect of prenatal education on fear of childbirth, pain intensity during labour and childbirth experience: a scoping review using systematic approach and meta-analysis. BMC Pregnancy Childbirth. 2023;23(1):541.
https://doi.org/10.1186/s12884-023-05867-0
13. Issac A, Nayak SG, Balakrishnan D, et al. Effectiveness of breathing exercise on the duration of labour: a systematic review and meta-analysis. J Glob Health. 2023;13:04023.
https://doi.org/10.7189/jogh.13.04023
14. Dashora U, Levy N, Dhatariya K, et al. Managing hyperglycaemia during antenatal steroid administration, labour and birth in pregnant women with diabetes. Diabet Med. 2022;39(2):e14744.
https://doi.org/10.1111/dme.14844
15. Stock SJ, Horne M, Bruijn M, et al. Development and validation of a risk prediction model of preterm birth for women with preterm labour symptoms. PLoS Med. 2021;18(7):e1003686.
https://doi.org/10.1371/journal.pmed.1003686
16. Pavlidis P, Eddy K, Phung L, et al. Clinical guidelines for caring for women with COVID-19 during pregnancy, childbirth and the immediate postpartum period. Women Birth. 2021;34(5):455-64.
https://doi.org/10.1016/j.wombi.2020.10.015
17. Atif M, Farooq M, Shafiq M, et al. The impact of partner’s behaviour on pregnancy related outcomes and safe child-birth in Pakistan. BMC Pregnancy Childbirth. 2023;23(1):516.
https://doi.org/10.1186/s12884-023-05814-z
18. Bein M, Yu OH, Grandi SM, et al. Levothyroxine and the risk of adverse pregnancy outcomes in women with subclinical hypothyroidism: a systematic review and meta-analysis. BMC Endocr Disord. 2021;21(1):34.
https://doi.org/10.1186/s12902-021-00699-5
19. Khan A, Khan N, Amin Z. Prevalence and risk factors of caesarean section in Pakistan. J Pak Med Assoc. 2021;71(3):845-849.
20. Saleem S, McClure EM, Goudar SS, et al. Maternal and perinatal outcomes in Pakistan: a community-based study. BMC Pregnancy Childbirth. 2020;20(1):315.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Indus Journal of Bioscience Research

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