Clinical utility of WHO-modified and paperless partographs in labor monitoring

The timely identification of deviations in labor progress and the prevention of prolonged labor are crucial to improving pregnancy outcomes. The partograph serves as a simple yet vital tool, offering a continuous visual representation of labor on a single sheet of paper, and is indispensable for effective labor monitoring.

The goal of a study was to examine labor progress using the WHO-modified partograph – considering alert and action lines, and a paperless partograph – considering estimated time of delivery alerts and actions––to identify any deviations from normal labor progress and assess the duration of labor, mode of delivery, and perinatal outcomes in both groups.

This was a prospective observational study spanning 18 months that involved 200 antenatal patients admitted to the Department of Obstetrics and Gynecology at Christian Medical College and Hospital, Ludhiana. Antenatal patients with singleton-term pregnancies and cephalic presentation who were in the active phase of labor were selected. The WHO-modified partograph was used for 100 cases (Group I), while an equal number of patients (Group II) had their labor progress recorded through a paperless partograph.

The findings relating to the labor duration, progress, mode of delivery, and neonatal outcomes were comparable between the WHO-modified and paperless partograph groups – with no statistically significant differences.

The results concluded that the paperless partograph is comparable to the WHO-modified partograph in predicting labor outcomes and detecting abnormalities. Since it does not require graphical representation, the paperless partograph is a viable alternative in busy labor room settings. Of note, a paperless partograph is equally effective in predicting labor progression, abnormalities, and outcomes as the WHO-modified partograph. 

Source: Bansal S, Mandrelle K, Varughese PV. Indian J Obstet Gynecol Res. 2023;10(4):403-407