Impact of real-time digital dashboard on birth outcomes in high-volume tertiary center: A retrospective cohort study

This study evaluates the impact of implementing a real-time intrapartum digital monitoring dashboard on labor progression and birth outcomes in a high-resource high-volume tertiary care delivery ward.

This retrospective cohort study was conducted at a university-affiliated medical center. We included all women admitted for an attempted vaginal delivery between January 2012 and December 2022. The intervention group included deliveries from January 2021 to December 2022, after full implementation of the dashboard. The control group included deliveries between January 2012 and May 2019, prior to implementation. Deliveries during the system's rollout phase (June 2019 to December 2020) and elective cesarean sections were excluded. The dashboard displayed real-time maternal and fetal data for all delivery rooms simultaneously. The primary outcome was labor duration, measured from admission to the delivery room until delivery. Secondary outcomes included prolonged second stage of labor, intrapartum fever, perineal lacerations (including obstetric anal sphincter injury), vacuum deliveries, and 5-min Apgar score < 7. Multivariable logistic regression and trend analyses were performed to adjust for potential confounders.

A total of 90 530 women were included in the study (70 922 pre-implementation and 19 608 post-implementation). After adjusting for maternal and clinical characteristics, dashboard implementation was associated with lower risk of labor >6 h (adjusted relative risk [aRR] 0.67, 95% CI 0.6-0.7) and prolonged second stage (aRR 0.64, 95% CI 0.5-0.7) and with fewer perineal lacerations (aRR 0.80, 95% CI 0.7-0.9). There were no significant differences in vacuum delivery rates or adverse neonatal outcomes.

Implementation of a real-time digital dashboard for intrapartum monitoring was associated with shorter labor and fewer perineal injuries without compromising neonatal safety, supporting a potential role for ward-wide digital monitoring in intrapartum care.