Fiftytwo health personnel who conduct deliveries in the labour ward were assessed before and after. Partograph or partogram is a simple, inexpensive tool which gives continuous pictorial overview of labour. This partograph, like others, is basically a graphic representation of the events of labour plotted against time in hours. Partogram the data collected was analyses by using descriptive statistics and inferential statistics. Perinatal forms guideline 4 a guide for completion of the. The objective of this endeavor was to site our experiences in. Grade x slcog national guidelines 10 table 1 partogram. Partograph is a greek word which means labour curve. There is reference in the meows booklet to lowering the threshold for escalation where preeclampsia is suspected. External experts and who staff involved in the preparation of the guideline 49 annex 2. Knowledge and utilization of partograph among obstetric care.
Documentation of the partograph in assessing the progress. Partogram partogram is a graphical record of all events of labour against time. Charts have traditionally contained preprinted alert and action lines. Its main purpose is to facilitate consistent and complete documentation, communication, and.
In the section of the partograph where cervical dilatation and descent of head are recorded, the scale to the left has the values from 0 to 10. Australian and new zealand journal of obstetrics and gynaecology, 492, pp. The single most important determinant to the mechanism of labor is probably pelvic configuration. Who recommendation on duration of the first stage of labour rhl. There is some evidence that appropriate use of partograph in monitoring the progress of labour could decrease delivery related complications. A study on the role of partograph in monitoring labour in high risk pregnancies background. Among the causes of these deaths were obstructed and prolonged labour which could be prevented by cost effective and affordable health interventions like the use of the partograph. Friedmans curve showing phase of maximum slope friedman divided labour functionally into two parts. A number of common partogram designs follow the work of philpott and castle and most incorporate an action line. Oct 16, 2017 who has recommended use of the partograph, a lowtech paper form that has been hailed as an effective tool for the early detection of maternal and fetal complications during childbirth. Value of the alert and action lines on the partogram. Relevant measurements might include statistics such as cervical dilation, fetal heart rate, duration of labour and vital signs.
Nyamtema as, urassa dp, massawe s, massawe a, lindmark g, van roosmalen j. This study assessed the effect of training on the knowledge and use of the partogram in lowrisk pregnancy lrp. Although most women and their babies are considered to be at low risk of complications at the onset of labour, 1, 2 the time around childbirth is associated with the highest risk of maternal and perinatal mortality and morbidity. You may use sources for many purposes, and the ways in which you refer to the source materials depend on those purposes.
To professor johanne sundby for the rich and profound academic guidance she offered throughout the study. The partogram, since its idealization and prescription, has been a target of discussion. Completion of the modified world health organization who. Related wnhs policies, procedures and guidelines wnhs policy. Acknowledgements i am greatly indebted to the following. The partograph sometimes known as partogram is usually a preprinted paper form on which labour observations are recorded. Relevant measurements might include statistics such as cervical dilation, fetal heart rate, duration of labour and vital signs it is intended to provide an accurate record of the progress in labour, so that any delay or deviation from. Physiologic partograph to improve birth safety and. Partogram definition of partogram by medical dictionary.
Within appropriatelydefined boundaries of safety, birth outcomes for nulliparous women are best when labor begins and progresses spontaneously. Ronel d, wiznitzer a, sergienko r, zlotnik a, sheiner e. A partograph is a preprinted paper that provides a visual display of recorded observations carried out on mother and foetus during labour. The correct completion of the partograph was very low. Pdf partogram and its relevance in modern obstetrics. As an obstetric tool, its usefulness and efficiency cut across resourcepoor and developed nations.
Knowledge and practice on partogram among staff nurses. Who recommendation on the use of active phase partograph. Summary of the considerations related to the strength of the recommendations balance worksheets 53. The lancet clinical practice value of the alert and action lines on the partogram b. Partograph use this form for monitoring active labour name of facility. Friedman in 1954, following a study on a large number of women in the usa, described a normal cervical dilatation pattern see fig. All 346 abstracts were screened to select publications in which partograph use was described in practice.
Ndiaye mtd d a public health research and training unit, prince leopold institute of tropical medicine, natinalestraat 155, b. Diagnostic accuracy of the partograph alert and action lines. Improving intrapartum care with better use of the partogram. The partogram is considered a valuable tool in the improvement of maternity services by allowing midwives and obstetricians to display intrapartum details in a pictorial manner. Among the five major causes of maternal mortality in developing countries like ethiopia hypertension, haemorrhage, infection, obstructed labour and unsafe abortion, the middle three haemorrhage, infection, obstructed labour are highly correlated with prolonged labour. Full text the use of the partograph in labor monitoring. The early latent phase extends over 810 hours and up to about 3 cm dilation. This references the presenting part to the level of the ischial spines measured in plus or minus centimeters. The progress of labour can be graphically represented using the who partogragh, which helps in early detection and prevention of complication of labour, thus resulting in a better fetomaternal outcome especially in high risk cases. Yet despite decades of training and investment, implementation rates and capacity to correctly use the partograph remain low in resourcelimited settings. A study on the role of partograph in monitoring labour in.
Partograph is an important tool to detect deviation from normal labour, and early referral helps in prevention of such castrotrophe. The partograph is a very useful graphical record of the course of labor that yields optimum results when employed in labor management by obstetric caregivers ocgs. The partogram was developed by dr friedman in 1954 and is a paper or electronic form that is used to record labour observations. Background the enormous challenge to maternal wellbeing with associated maternal wastages during labour has remained an unsurmountable problem in cameroon which reflects the current high maternal mortality rate. To god the father and creator and to jesus my saviour, to him is glory and honour. Partogram use in the dar es salaam perinatal care study. Effect of training on the knowledge and use of the. Point of reference has been really wonderful for me to work with over the years at a few different companies, and its a true partnership. The aim of the present study was to determine the extent to which health care workers are making use of the partograph in monitoring the progress of labour through checking.
Who recommendation on duration of the first stage of. Effect of partogram use on outcomes for women in spontaneous labour at term. Physiological parameters included in our meows chart. Interactive partogram partograph labor curve and calculator. Analysis of uterine rupture at university teaching hospital pakistan. Critical and important outcomes for decisionmaking 52 annex 3. This study aimed to evaluate the nonphysician obstetric caregivers ocgs knowledge of partograph use, assess the extent of its use, determine the factors that impede its usage, and unravel the relationship between years of experience and partograph use among the respondents ocgs in general hospital, calabar, nigeria. It is a composite graphical record of cervical dilation and descent of head against duration of labor in hours. Partogram has proven to be a simple and useful tool in monitoring normal labor. Globally, there was an estimated number of 287,000 maternal deaths in 2010.
Utilization of partographs allow for early identification of abnormal labour and referral for advanced care to emergency obstetric care emoc facilities. The percent of deliveries correctly monitored with a partogram sometimes known as a partograph. Knowledge and utilization of partograph among obstetric. Pdf on feb 20, 2016, ruchika garg and others published study of various labour abnormalities with reference to composite partogram find, read and cite all the research you need on researchgate. All facilities were using the modified who partograph. The aim of partogram is to provide a pictorial overview of labour, to alert midwives and obstetricians to deviations in maternal or fetal wellbeing and labour progress. The documentation of parameters of partographs is however, poorly understood. A study to assess the knowledge regarding partograph among. It provides a visual representation of labour, to alert midwives and obstetricians to deviations in maternal or fetal wellbeing and measure labour progress. Eighty five percent 245,000 of these deaths occurred in subsaharan africa and southern asia. The common obstetric emergencies are obstructed labour and prolonged labour. It is a composite graphical record of cervical dilation and descent of.
The study was undertaken at hitech medical college and hospital, bhubaneswar from march 2017 to february 2019 on 200 high risk patients. The partograph or partogram is recommended by the world health organisation who, for monitoring labour wellbeing and progress. Pdf study of various labour abnormalities with reference. When a oneway anova was performed on the maternal satisfaction data, highly significant differences were found p partogram bcphp 1583 is a revised form developed to facilitate the assessment and documentation of pertinent information about labour and birth in a structured, logical and standardized manner. Because the cesarean rate for lowrisk, term, nulliparous women is a reliable indicator of obstetrical care quality,, the current u. Using the partograph study session 4 using the partograph introduction. Recommendation to facilitate monitoring during labour a partogram is recommended. This is an analytical before and after study at the lagos university teaching hospital. Partograph a partograph is a graphical record of the observations made of a women in labour for progress of labour and salient conditions of the mother and fetus it was developed and extensively tested by the world health organization who. Frequency and percentage distribution was used for demographic variables and assessing the knowledge and practice on partogram. Percent of deliveries in which a partogram is correctly used. Pdf study of various labour abnormalities with reference to. Who has recommended use of the partograph, a lowtech paper form that has been hailed as an effective tool for the early detection of maternal and fetal complications during childbirth. Thorsen for the untiring academic guidance throughout my research work.
Barriers to and incentives for achieving partograph use in. Maintenance of the partogram is commenced once the mother is admitted to the labour suite. Ive always felt that if i require a new process, or for something to work a little bit differently, that they listen. Partogram use is important for early recognition of deviations in labour. This was followed by an active phase, characterized by acceleration from about 310 cm at the end of which deceleration occurred. Partograph is the graphic statistical analysis of progress of labour in primigravida and multipara. A crosssectional study of partograph utilization as a. History of partogram friedmans partogram devised in 1954 was based on observations of. Trends, risk factors and pregnancy outcome in women with uterine rupture. Jan 18, 20 globally, there was an estimated number of 287,000 maternal deaths in 2010. The partogram is a printed chart on which observations in labor are recorded in a graphic format to provide an overview of labor, aiming to alert midwives and obstetricians to deviation in labor progress as well as maternal or fetal wellbeing. It is essen al that you provide references to the ideas, facts, quota ons etc. Who recommendations for augmentation of labour 1 acknowledgements work on this guideline was initiated by a. A guide to reference and documentation y making explicit the sources of your ideas and information, you let the reader know the full extent of the conversation in which you are taking part.
Metin gulmezoglu, joao paulo souza and mariana widmer, of the who department of reproductive health and research, and matthews mathai, of the who department of maternal, newborn, child and adolescent health. Likewise, submit the parturient to repeated vaginal examination, besides being extremely inconvenient, can facilitates the possibility of. The partogram sometimes known as partograph is usually a preprinted paper form on which labour observation are recorded. Percent of deliveries in which a partogram is correctly. National guidelines management of uncomplicated labour.
Role of a second stage partogram in predicting the outcome of normal labour. The aim of the partograph is to provide a pictorial overview of labour, and to alert midwives and obstetricians to deviations in maternal or fetal wellbeing and labour progress. Nurses and midwives years of professional experience as well as having received training in managing pregnant mothers in. Evidence abounds that costeffective and affordable health interventions like the use of the partograph will contribute to curb the alarming number of intrapartum maternal deaths. There were 346 references after removal of duplicates. There is no laboratory test that gives a labor titer or an xray procedure that can define the difference between the laboring and nonlaboring patient. Who recommendation on the use of active phase partograph with a four hour action line for monitoring the progress of labour. Partograph definition of partograph by medical dictionary. This uptodate, comprehensive and consolidated guideline on essential intrapartum care brings together new and existing who recommendations that, when delivered as a package, will ensure goodquality and evidencebased care irrespective of the setting or level of health care. By tradition, the values 0 to 5 are used to record the level of fetal descent. The british columbia labour partogram bcphp 1583 is a revised form developed to facilitate the assessment and documentation of pertinent information about labour and birth in a structured, logical and standardized manner.
Partograph contain preprinted alert and action lines. One study presenting data separately for women with parity of 1 and parity of more than 1, with reference points for active phase starting from 5 cm, reported median durations of 3. The definition or clinical diagnosis of labor is a retrospective one. Introduction the who maternal and child health and family planning. The first clinical observation recorded on the meows chart is the booking blood pressure with.
1338 1513 223 401 164 333 580 536 1328 936 803 557 841 1181 1162 960 471 993 659 940 1035 110 1390 1085 634 997 235 1258 1208 754 405 654 1340 1059