The Utility of Partogram in Management

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:

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