Observations during the established first stage of labour (charting of observations)

Bibliographic reference Study type Evidence level Number of women Women’s characteristics Intervention Comparison Length of follow-up Outcome measures Effect size Source of funding Additional comments
WHO 1994 Jun 4301RCTEvidence level: 1+8 hospitals (partogram=4 no partogram=4), and 35484 womenwomen in labourIntervention: use of WHO partogramComparison: no partogramFollow-up period: intra-partum periodOutcome Measures: length of labour, mode of deliveries, augmentation, postpartum sepsisall nulliparous normal women:

Duration of labour (median, (5–95 percentile)
No partogram=5.58h (1.17–21.9)
Partogram=5.75h (1.40–17.7)
p=0.518

Women whose labour lasted > 18h
RR 0.56 [0.47 to 0.67]
NNT 30.13

Labour augmented
RR 0.43 [0.39 to 0.47]
NNT 5.44

postpartum sepsis
RR 0.09 [0.03–0.31]
NNT 136.84

Spontaneous Cephalic delivery
RR 1.05 [1.03 to 1.08]
NNT 25.49

cs
RR 0.70 [0.61 to 0.81]
NNT 34.21

all parous normal women:

Duration of labour (median, (5–95 percentile)
No partogram=2.83h (0.42–15.2)
Partogram=3.08h (0.60–13.1)
p=0.245

Women whose labour lasted > 18h
RR 0.40 [0.30 to 0.52]
NNT 47.46

Labour augmented
RR 0.39 [0.35 to 0.44]
NNT 7.89

Postpartum sepsis
RR 0.39 [0.17 to 0.93]
NNT 477.53

Spontaneous cephalic delivery
RR 1.02 [1.00 to 1.03]
NNT 71.03

CS
RR 0.75 [0.61 to 0.93]
NNT 114.18
the WHO Safe Motherhood Operations Research and the Special Programme of Research, Development and Research Training in Human Reproduction

From: Evidence tables

Cover of Intrapartum Care
Intrapartum Care: Care of Healthy Women and Their Babies During Childbirth.
NICE Clinical Guidelines, No. 55.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2007 Sep.
Copyright © 2007, National Collaborating Centre for Women’s and Children’s Health.

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