Points to remember while using Partograph Ø It is only a tool for managing labour progress
Ø Only start partograph who don’t have complications and doesn't require Referral. Ø Progress of labour is satisfactory, if the plotting of cervical dilation remain on/to the left of the Alert line Ø Cervical dilation plotted as ‘X’ Ø Assessing descent of the head helps in detecting progress of labour Ø Infrequent vaginal examination (once in every 4hrs) Ø When the woman arrives to the hospital the time of admission is “O” time Ø A woman whose cervical dilation moves to the right of the Alert line must be transferred for obstetric interventions
Case A •
Glenda was admitted at 12:00pm, G2 P1, BP=110mmHg,, PR = 90bpm,
FHR,=130bpm, T=36.8CIE showed 5cm dilated cervix Still with (+) BOW •
At 4pm, FHR=140bpm, cervix dilatation is 7cm,
BP=120/90mmHg, (+)BOW •
At 5:00pm, cervix was 9cm (-) BOW clear, she delivered spontaneously at 5:30pm. 10U oxytocin given IM. Placenta was delivered at 5:30pm.
Quick action warranted in labour during following conditions •
Delay in cervical dilatation is 1cm/hr
•
Delay in descent of the head
•
FHR < 120 or > 160/min. on 3 observation
•
ROM and Meconium stained
•
ROM and Absence of liquor and fetal skull Moulding with bones touching each other / overlapping / severe overlapping
CONCLUSION •
The partograph gives healthcare providers objective data on which to base their clinical decisions and enhances communication among members of the team of providers who are caring for the mother, so that decisions can be made in a timely manner.
