WHO-Labour Care Guide helps to reduce C-section deliveries: Safdarjung study

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Rohit Shishodia

A study, carried out by the Department of Obstetrics and Gynaecology in Delhi’s Safdarjung Hospital–Vardhman Mahavir Medical College, has revealed that implementation of the World Health Organisation’s (WHO) Labour Care Guide (LCG) has helped in reducing Caesarean Section (CS) aided deliveries significantly.

 

The study, led by Divya Pandey, Rekha Bharti, and Anjali Dabral, has found that the CS rate was significantly less at 1.8% among the study group using LCG in comparison to 17.3% in the control group.

Explaining the findings of the study, Dr Achla Batra, President, The Association of Obstetricians and Gynecologists of Delhi and Professor, Department of Obstetrics and Gynaecology, Safdarjung Hospital, said, “In general 17.3% of women with uncomplicated pregnancy remain at the risk of CS, but when we followed WHO-LCD, the incidences of CS intervention among the group came down to 1.8%. The guidelines recommend more waiting for delivery if mother and foetus are in no danger.”

“The duration of the active phase was significantly smaller in the study group. The two groups were similar in terms of pregnancy-related complications, duration of hospital stay and APGAR score,” the study findings noted.

This randomised controlled study was done on 230 low-risk antenatal women admitted in spontaneous labour at a tertiary teaching hospital over four months.

As per the inclusion and exclusion criteria, 115 women were allocated to study and control each group.

Respectful maternity and supportive care to expecting mothers are the major constituents of this LCG in addition to continuous monitoring of women in labour.

The outcomes were the mode of delivery and labour-outcome parameters like duration of active labour, maternal complications, duration of hospital stay, APGAR (5 minutes) score and The Neonatal Intensive Care Unit (NICU) admission.

The parameters in both groups were recorded and compared using SPSS 21.0 software for statistical analysis.

WHO –Labour Care Guide (LCG)-the next generation partograph was introduced in December 2020 for the application of new definitions of stages of labour by WHO in February 2018.

Dr Divya Pandey, Associate Professor from the Department of Obstetrics and Gynaecology of  Vardhman Mahavir Medical College and lead author of the study said that this is the first-ever study conducted in India to understand the effect of following WHO-LCG in case of uncomplicated pregnancies.

She said that a maximum number of CS are needed to be performed in expecting mothers who had already undergone CS earlier.

“If we prevent primary caesareans, then major contributors of the surgery are reduced. Our focus is to control caesareans. We introduced this labour guide on low-risk groups,” Dr Pandey pointed out.


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