Fig. 1.
Sections of the LCG
WHO LABOUR CARE GUIDE
Name Parity Labour onset Active labour diagnosis [Date ]
Section 1 Ruptured membranes [Date Time ] Risk factors
Time : : : : : : : : : : : : : : :
Alert Hours 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3
column ALERT ACTIVE FIRST STAGE SECOND STAGE
SUPPORTIVE CARE
Companion N
Pain relief N
Section 2 Oral fluid N
Posture SP
Baseline
FHR <110, ≥160
FHR L
deceleration
Amniotic fluid M+++, B
Section 3
BABY
Fetal position P, T
Caput +++
Moulding +++
Pulse <60, ≥120
Systolic BP <80, ≥140
WOMAN
Section 4 Diastolic BP ≥90
Temperature ºC <35.0,
≥ 37.5
Urine P++, A++
Contractions
≤2, >5
per 10 min
Duration of <20, >60
contractions
10
9 ≥ 2h In active first stage, plot ‘X’ to
Cervix 8 ≥ 2.5h record cervical dilatation. Alert
LABOUR PROGRESS
[Plot X] triggered when lag time for
7 ≥ 3h current cervical dilatation is
exceeded with no progress. In
Section 5 6 ≥ 5h
second stage, insert ‘P’ to indicate
5 ≥ 6h when pushing begins.
5
4
Descent 3
[Plot O]
2
1
0
Oxytocin (U/L, drops/min)
MEDICATION
Section 6 Medicine
IV fluids
SHARED DECISION-MAKING
ASSESSMENT
Section 7
PLAN
WHO LABOUR CARE GUIDE: USER’S MANUAL
INITIALS
INSTRUCTIONS: CIRCLE ANY OBSERVATION MEETING THE CRITERIA IN THE ‘ALERT’ COLUMN, ALERT THE SENIOR MIDWIFE OR DOCTOR AND RECORD THE ASSESSMENT AND ACTION TAKEN.IF LABOUR EXTENDS BEYOND 12H,
PLEASE CONTINUE ON A NEW LABOUR CARE GUIDE.
Abbreviations: Y – Yes, N – No, D – Declined, U – Unknown, SP – Supine, MO – Mobile, E – Early, L – Late, V – Variable, I – Intact, C – Clear, M – Meconium, B – Blood, A – Anterior, P – Posterior, T – Transverse, P+ – Protein, A+ – Acetone
4
ANNEX 1
WHO Labour Care Guide
WHO LABOUR CARE GUIDE
Name Parity Labour onset Active labour diagnosis [Date ]
Ruptured membranes [Date Time ] Risk factors
Time : : : : : : : : : : : : : : :
Hours 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3
ALERT ACTIVE FIRST STAGE SECOND STAGE
SUPPORTIVE CARE
Companion N
Pain relief N
Oral fluid N
Posture SP
Baseline <110, ≥160
FHR
FHR
deceleration L
Amniotic fluid M+++, B
BABY
Fetal position P, T
Caput +++
Moulding +++
Pulse <60, ≥120
Systolic BP <80, ≥140
WOMAN
Diastolic BP ≥90
Temperature ºC <35.0,
≥ 37.5
Urine P++, A++
Contractions ≤2, >5
per 10 min
Duration of <20, >60
contractions
10
9 ≥ 2h In active first stage, plot ‘X’ to
Cervix 8 ≥ 2.5h record cervical dilatation. Alert
LABOUR PROGRESS
[Plot X] triggered when lag time for
7 ≥ 3h current cervical dilatation is
6 ≥ 5h exceeded with no progress. In
second stage, insert ‘P’ to indicate
5 ≥ 6h when pushing begins.
5
4
Descent 3
[Plot O]
2
1
0
Oxytocin (U/L, drops/min)
MEDICATION
Medicine
IV fluids
WHO LABOUR CARE GUIDE: USER’S MANUAL
SHARED DECISION-MAKING
ASSESSMENT
PLAN
INITIALS
INSTRUCTIONS: CIRCLE ANY OBSERVATION MEETING THE CRITERIA IN THE ‘ALERT’ COLUMN, ALERT THE SENIOR MIDWIFE OR DOCTOR AND RECORD THE ASSESSMENT AND ACTION TAKEN.IF LABOUR EXTENDS BEYOND 12H,
PLEASE CONTINUE ON A NEW LABOUR CARE GUIDE.
Abbreviations: Y – Yes, N – No, D – Declined, U – Unknown, SP – Supine, MO – Mobile, E – Early, L – Late, V – Variable, I – Intact, C – Clear, M – Meconium, B – Blood, A – Anterior, P – Posterior, T – Transverse, P+ – Protein, A+ – Acetone
24
