title: Comparison of two WHO partographs: a one year randomized controlled trial.
abstract: OBJECTIVE
  To compare two World Health Organization (WHO) partographs - a composite partograph including the latent phase with a simplified one without the latent phase in women with uncomplicated pregnancy.
  
  
  METHODS
  This was a randomized controlled trial conducted at a tertiary hospital at Belgaum, India. 743 women with term, singleton, vertex gestation, in spontaneous labor were included in the study over a period of one year. Either of the partographs was used on laboring women. The following outcomes were compared: labor crossing the alert and action line, augmentation of labor, rate of cesarean section, perinatal outcome, user friendliness and maternal complications. Statistical analysis was done using Chi-square test.
  
  
  RESULTS
  Labor values crossed the alert and action lines significantly more often when composite partograph was used (p<0.001) in each, with increased number of augmentations (p<0.001). The number of vaginal deliveries were high (p<0.005) in the simplified group. There was no significant difference in the rate of cesarean deliveries due to non progress of labor in both groups (p=0.68). NICU admissions were higher in the composite group (p=0.035). Most resident doctors (93%) experienced difficulty with the composite partograph, but no resident doctor reported difficulty with the simplified partograph. The mean SD user friendliness score was lower for the composite partograph (2.87±1.86 vs 10.67±1.61; p<0.005).
  
  
  CONCLUSIONS
  The WHO simplified partograph is easier to use and is a better option for both the laboring women and the user, when compared to composite partograph.
authors.affiliation: Department of Obstetrics and Gynaecology, Kle University, Jawaharlal Nehru Medical College, Belgaum, Karnataka, India.
authors.forename: Swamy Mallaiah
authors.initials: SM
authors.lastname: Kenchaveeriah
authors.affiliation: Department of Obstetrics and Gynaecology, Kle University, Jawaharlal Nehru Medical College, Belgaum, Karnataka, India.
authors.forename: Kamal Prakash
authors.initials: KP
authors.lastname: Patil
authors.affiliation: Department of Obstetrics and Gynaecology, Kle University, Jawaharlal Nehru Medical College, Belgaum, Karnataka, India.
authors.forename: Tania Gurudeep
authors.initials: TG
authors.lastname: Singh
keywords: World Health Organization; action line; alert line; latent phase; partograph; user friendliness