Trial reportInternational journal of women's health2025
Effectiveness of the Modified WHO Labour Care Guide to Detect Prolonged and Obstructed Labour Among Women Admitted at Eight Publicly Funded, Midwife-Led Community Health Facilities in Rural Mbarara District, Southwestern Uganda: An Ambispective Cohort Study.
Trial report in International journal of women's health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Maternal near miss incidence ratio, its causes and risk factors in East Africa: a systematic review and meta-analysis.Reproductive health · 2025Pooled it
- Associations between organizational readiness and implementation fidelity in national implementation of WHO's labour care guide in Sweden: a prospective observational study.Implementation science communications · 2026Article
- A Comparative Observational Study on the WHO Labour Care Guide Versus the WHO Modified Partograph on Labour Outcome.Cureus · 2026Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
Background: Obstructed labour, a sequel of prolonged labour, remains a significant contributor to maternal and perinatal deaths in low resource settings. Objective: We evaluated the modified WHO labour care guide (LCG) in detecting prolonged/obstructed labour compared to the traditional partograph at publicly funded maternity centers in Southwestern Uganda. Methods: LCG was deployed to monitor labour by trained health care providers in 2023. We reviewed all patient labour monitoring records for the first quarter of 2024 (LCG-intervention) and 2023 (partograph-before LCG introduction) from eight randomized maternity centers. Our primary outcome was the proportion of women diagnosed with prolonged and or obstructed labour. Secondary outcomes included: mode of delivery, labour augmentation, stillbirths, maternal deaths, Apgar score, uterine rupture, postpartum haemorrhage and tool completion. Data was collected in REDcap and analyzed using STATA v17; statistical significance was p < 0.05. Results: A total of 991 (49.3%) and 1020 (50.7%) women were monitored using the LCG and partograph, respectively. The mean maternal and gestation ages were similar between the two groups, reported at 25.9 (SD=5.6) years, and 39.4 (SD=1.8) weeks, respectively. Overall, 120 (12.4%) cases of prolonged/obstructed labour were diagnosed (100 for LCG versus 20 for partograph); LCG had six times higher odds of diagnosing prolonged/obstructed labour compared to the partograph (aOR = 5.94;CI 95%3.63-9.73, P < 0.001). Detection of obstructed labour alone using LCG increased 12-fold compared to the partograph (aOR = 11.74;CI 95%3.55-38.74, P < 0.001). We observed increased Caesarean section rates (aOR=6.12;CI 95%4.32-8.67, P < 0.001), augmentation of labour (aOR = 3.11;CI 95%1.81-5.35, P < 0.001), Apgar Score at 5 minutes (aOR = 2.29;CI 95%1.11-5.77, P = 0.025) and tool completion rate (aOR = 2.11;CI 95%1.08-5.44, P < 0.001). We observed no differences in stillbirths, maternal deaths, postpartum haemorrhage and uterine rupture. Conclusion: Our data shows that LCG diagnosed more cases of prolonged and obstructed labour compared to the partograph among women delivering at rural publicly funded midwife-led facilities in Southwestern Uganda. More controlled and powered studies should evaluate the two tools in different facilities and sub-populations. Trial Registration: This trial registration was registered with
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