Tashkent, Uzbekistan (UzDaily.com) -- The World Health Organization has adopted new recommendations for the management of childbirth. Uzbekistan, taking full account of these new data, has developed a national clinical protocol.

Not only to develop and accept, but also to take into account all the nuances based on the best international experience - this is the path taken in such an important issue as obstetric care by the Republican Specialized Scientific and Practical Medical Center for Maternal and Child Health. For this purpose, consultations are being held with international WHO experts, the next of which took place on 25 January.

What is the essence of the new WHO approach? If we speak for a broad understanding, then the point is that a woman should enter the delivery room not at the first sign, but precisely for medical reasons - already in the active phase when labor is progressing with the required intensity. Of course, this approach is applicable for normal uncomplicated childbirth.

This is how the WHO expert, MD Tinatin Gagua, explained the problem of the traditional approach to childbirth that exists today in many countries. When entering the delivery room at the very initial signs of labor and before the active phase, the woman in labor sometimes stays in it for several hours, which forces doctors to decide inducing labor. However, in this condition, stimulation does not produce results, which often leads to another solution - a cesarean section. At the same time, a woman’s admission to the delivery room precisely in the active phase of labor, when she reaches the WHO recommended indicators, usually leads to such positive outcomes as: shorter stay in the delivery room, reduction in the number of unnecessary medical interventions, more frequent vaginal delivery , reducing the frequency of cesarean sections. A woman who is already having contractions, but has not entered the active phase, can be observed by doctors in a medical facility, but not admitted to the delivery room.

The WHO expert placed special emphasis on the fact that it was the healthcare system of Uzbekistan that followed the path of full compliance with WHO recommendations. As was emphasized by the expert and the leadership of the Russian National Medical Research and Medical Center, this does not mean that after the adoption of the corresponding national protocol, all obstetric services in Uzbekistan will immediately switch to new requirements.

As Natalya Nadyrkhanova, director of the Russian National Research and Medical Center, noted, first of all, there will be a lot of training on the provisions of the new protocol. Moreover, in the regions, local standards are being developed based on the national protocol, taking into account the real available capabilities. And, of course, any questions that arise can be clarified with specialists from the Republican Center for Maternal and Child Health and its branches, which operate in all areas.

There will also be training in filling out and maintaining the so-called “Partogram”. A partogram is a chart that is completed by health care providers for all women who have entered labor. The partogram contains data on the condition of the woman and her unborn baby, as well as indicators of the labor process on an hourly basis.

This allows doctors to evaluate and reassess the situation every hour and make decisions regarding whether or not it is necessary to interfere with the natural process of labor. The WHO recommended the partograph as a tool for monitoring mothers in labor back in 1987, but the partograph has now been updated in accordance with new scientific research and evidence. The main innovation was that the process of labor in the partogram must be reflected from the active phase of the first stage of labor, and not earlier.

The National Clinical Protocol “Partogram” was developed in connection with new WHO recommendations adopted in 2022. Based on the analysis of new international evidence-based medicine, WHO has revised the structure of the previous version of the partograph in order to facilitate the effective implementation of recommendations for the management of normal labor, to ensure the well-being of the woman and the fetus during childbirth.