PARTOGRAM
INTRODUCTION:
- PARTOGRAM is a graphical information about the progress of labour in which the salient information about the fetal well-being, maternal well-being and the progress of labour are recorded into a chart.
SIGNIFICANCE:
- Is a managerial tool used to record all observations made on a woman and fetus in labour in one chart.
- Partogram helps to identify at an early stage those women whose labour is slow.
- A managerial tool for prevention of prolonged labour.
INDICATION:
- Records fetal condition, labor progress, and maternal condition
- Detects insufficient uterine action, Obstructed labour and/or cephalopelvic disproportion
- Helps reduce prolonged labor and its sequelae
COMPONENTS:
- Patient identification
- Time: It is recorded at an interval of one hour. Zero time for spontaneous labour is time of admission in the labour ward and for induced labour is time of induction.
- Fetal heart rate: It is recorded at an interval of thirty minutes.
- State of membranes and colour of liquor: “I” designates intact membranes, “C” designates clear and “M” designates meconium stained liquor.
- Cervical dilatation and descent of head
- Uterine contractions: Squares in vertical columns are shaded according to duration and intensity.
- Drugs and Fluids
- Blood pressure: It is recorded in vertical lines at an interval of 2 hours.
- Pulse rate: It is also recorded in vertical lines at an interval of 30 minutes.
- Oxytocin: Concentration is noted down in upper box; while dose is noted in lower box.
- Urine analysis
- Temperature record
- Normal partogram include
- Descent of head in Y – axis
- Sigmoid shaped curve
- Alert line followed 4 hours later by action line
ADVANTAGES:
- Provides information on single sheet of paper at a glance
- No need to record labour events repeatedly
- Prediction of deviation from normal progress of labour
- Improvement in maternal morbidity, perinatal morbidity and mortality
CALCULATION:
- The indicator is calculated for a specific reference period as:
# of deliveries correctly monitored with a partogram x 100
__________________________________________
Total # of deliveries
Exam Important
- Assessment of progress of labour is best done by Partogram
- Normal partogram include
- Descent of head in Y – axis
- Sigmoid shaped curve
- Alert line followed 4 hours later by action line
- Partogram helps in detecting Obstructed labour
- Partogram is a graphic record of Labour
- Partogram is the graphical record of cervical dilatation in centimeters against duration of labour in hours
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