The Utility of Partogram in Management

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Overview

The partograph serves as "early warning system" and it has shown to be effective in preventing prolonged labour, in reducing operative interventions and in improving the neonatal outcome. "A picture is worth a thousand words". A partograph review if well recorded provides rapid and comprehensive information about progress of labour when compared with a review of detailed handwritten case sheets. Partograph is a Latin/Greek hybrid word synonymous with parturition recorded in a graphic form.

labour is a natural physiological process characterized by progressive increase in the frequency, intensity and duration of uterine contractions, resulting in effacement and dilatation of the cervix with descent of the foetus through the birth canal. This physiological process may take time lead to pathological one and failure to recognize this would result in prolonged labour with the resultant increase in the intensity in the morbidity and mortality of both foetus and the mother.This leads to surgical intervention with further danger to both the mother and foetus. Hence, prolonged labour and obstructed labour must be prevented by timely and effective measures, so as to give the mother a safe and happy experience of labour and child birth. The safe mother hood initiative (SMI) emphasises that the monitoring of labour for early detection of dystocia is one of the most important approaches for reducing maternal and neonatal morbidity and mortality. In this context, the partogram has been adopted by the WHO (World health Organization) to monitor labour in maternity clinics in developing countries as a simple managerial tool to prevent prolonged labour, obstructed labour and its sequelle. The paperless partograph refers to monitoring progress of labour and reaching to an accurate decision for intervention to ensure safe delivery. The partograph, a graphic recording of progress of labour and salient features in the mother and foetus has been used to detect labour that is not progressing normally, to help in early decision on augmentation and termination of labour. WHO partograph is a composite graphic representation of events that takes place in labour plotted against time in hours on a pre-printed paper. It consists of three parameters:

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

DIAGNOSTIC

Masking

NONE

Enrollment

200

Conditions

Labor Onset

Interventions

PartogramPROCEDURE

to evaluate the utility of partogram in management and progress of active labor in Primigravidae.

Eligibility

Sex: FEMALEMin age: 20 YearsMax age: 35 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Primigravida, 20 and 35 years old * Gestational age 37 - 41 weeks with vertex presentation * Singleton pregnancy * Spontaneous or induced labour * First stage of labour with cervical dilatation \< than 7 cm. Exclusion Criteria: * Abnormal presentation * Macrosomic baby * Contacted pelvis * Multifetal gestations * Antepartum haemorrhage * Cases with high risk pregnancy as Severe PIH, Severe anaemia and gestational diabetes mellitus. * Patient refused to enrolled in the research

Locations (1)

Al-Azhar University hospitals

Asyut, Egypt

Outcomes

Primary Outcomes

Mode of Delivery

The mode of delivery was assessed by the condition of the mother and the fetus by BISHOP score (The Bishop score is a cervical assessment system used to predict the success of labor induction. This scoring system evaluates several clinical parameters of the cervix, including dilation, effacement, position, consistency, and the fetal head's station in the pelvis).

Time frame: 24 hours

Data from ClinicalTrials.gov

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