To explore the impacts of the intrapartum ultrasound monitoring of fetal heart combined with the new partogram management for primiparas on the delivery modes and the pregnancy outcomes of the primiparas. Methods: The primiparas with singleton and full-term pregnancy who wanted vaginal trial delivery in hospital were selected and were divided into two groups according to the different intrapartum monitoring methods from October 2022 to October 2023. The primiparas in group A were given intrapartum electronic monitor combined with new partogram management. And the primiparas in group B were given intrapartum color Doppler ultrasound monitoring combined with new partogram management. After excluding the confounding factors of the baseline data of the primiparas by propensity score matching method, 134 primiparas in each group were obtained for analysis. The delivery modes, the duration of different stage of labor, the postpartum pelvic floor muscle function (activity value, work value and peak value), and the adverse delivery outcomes of the primiparas were compared between the two groups. Results: The rate of cesarean section (22.4%) of the primiparas in group B was significantly lower than that (34.3%) of the primiparas in group A. The durations of the first stage of labor (10.5±0.8h) and the second stage of labor (79.5±11.5min) of the primiparas in group B were significantly shorter than those (10.8±1.0h and 93.4±13.2min) of the primiparas in group A. The activity value, work value and peak value of the pelvic floor muscle of the primiparas with vaginal delivery in the two groups were significantly lower than those of the primiparas with cesarean section (P<0.05). There was no significant difference in the incidence of adverse delivery outcomes of the primiparas between the two groups (P>0.05). Conclusion: The application of the intrapartum ultrasound monitoring of fetal heart and the fetal position combined with the new partogram management for the primiparas can shorten their delivery stage duration, reduce their cesarean section rate and improve the maternal-infant outcomes.