From: Reducing stillbirths: screening and monitoring during pregnancy and labour
Source | Location and Type of Study | Intervention | Stillbirths/Perinatal Outcomes |
---|---|---|---|
Reviews and meta-analyses | |||
Lavender et al. 2008 [140] | England and South Africa. Meta-analysis (Cochrane). 5 RCTs included; 3 reported serious neonatal morbidity or PMR. N = 6963 women. | Assessed the use of partograph vs. no partograph; and compared impact of different versions of partograph (e.g. partogram with 2-hr, 3-hr, 4-hr, or no action line). | Serious neonatal morbidity or PMR: OR not estimable. [0/1805 vs. 0/1796 in the 2-hour vs. 4-hour action line groups, respectively]. |
Intervention studies | |||
Fahdhy 2005 [148] | Indonesia (Medan City). Cluster RCT. 20 midwives in maternity homes. N = 626 pregnant women with vertex presentations (N = 304 intervention, N = 322 controls). | Assessed the impact of the use of the WHO partograph by trained midwives (intervention) vs. standard midwifery care without partograph (controls). 92% of partographs correctly completed; N = 71 had graph beyond alert line. 42/71 referred to hospital. | Fetal death: adj. OR = 0.62 (95% CI: 0.17–2.19) [NS] [5/304 vs. 7/302 in intervention vs. control groups, respectively.] END: adj. OR = 0.70 (0.16–3.11) [NS] [3/304 vs. 7/302 in intervention vs. control groups, respectively.] Significant decreases in obstructed labour, oxytocin use:, Apgar <7 at 1 min: No difference in Caesarean section rate, Apgar <7 at 5 min, or prolonged labour. |
Lennox 1998 [147] | Indonesia, Thailand, Malaysia. Hospital-based study. Multicentre. Before-after study. 8 hospitals. N = 1740 breech presentation pregnancies (N = 817 after, N = 923 before). | Assessed the impact of use of the partograph with an agreed labour-management protocol on perinatal outcomes. | Intrapartum SB (breech): 1.1% vs. 1.9% after vs. before, respectively. [NS] Prolonged labour: Significant reduction with partograph (P < 0.05) |
WHO 1994 [146] | Indonesia, Thailand, Malaysia. Hospital-based study. Multicentre. Quasi-RCT. 8 hospitals. N = 35,484 women. | Assessed the impact of use of the partograph with an agreed labour-management protocol on perinatal outcomes. | Intrapartum SB: 0.3% vs. 0.5% in intervention vs. control groups, respectively. Prolonged labour: 3.4% vs. 6.4% in intervention vs. control groups, respectively. Oxytocin augmentation: 9.1% vs. 20.7% in intervention vs. control groups, respectively. Emergency Caesarean sections: 8.3% vs. 9.9% in intervention vs. control groups, respectively. |