Implication of the Two WHO Partographs, (Composite and Simplified) Regarding Maternal and Neonatal Outcome

Abstract

Partograph is an inexpensive tool that serves as an "early warning system" and can assist in early decision making on transfer, augmentation, and termination of labor. This is a randomized prospective comparative study conducted at Al- Elwiya Maternity teaching Hospital in Baghdad-Iraq. The objective of this work is to compare two World Health Organization (WHO) Partographs, the composite Partograph including the latent phase with the simplified one without latent phase regarding maternal and fetal outcomes. Study sample consisted of 670 women with term, singleton, vertex presentation, in spontaneous labor. Either Partograph was used on laboring women. The following outcomes: labor crossing the alert and action line, augmentation of labor, rate of cesarean section, maternal complications, user friendliness and perinatal outcome were compared. Labor values crossed the alert and action line was significantly more often with composite Partograph (P< 0.001). Augmentation of labor have been significantly required more in cases of composite group (p- value <0.001). Vaginal deliveries were higher in cases monitored with the simplified group (p<0.005). Cesarean section was more in cases monitored with composite Partograph (p-value <0.001). Admission to the neonatal care unit was more in cases of composite Partograph group, weather the patients were nulliparous or multiparous, the difference was statically significant (p<0.005). Most users (91%) had trouble with composite Partograph, but no resident doctor reported difficulty with simplified Partograph. It was concluded that the World Health Organization simplified Partograph is easier to use and is a better option for both the laboring women and the user, when compared to the composite Partograph.