PartographPROF:JOHN ANTHONY OCTUBRE RN,MAN

PARTOGRAPH

Graphic recording of the progress of labour

Recording of salient conditions of the mother and fetus

Uses

To detect labour that is not progressing normally

To indicate when augmentation of labour is appropriate

To recognize CPD long before obstruction occurs

Partograph

Increases the quality of all observations on the mother and fetus in labour

Serves as an Early warning system

Assists in early decision on transfer, augmentation, termination of labour

Who should not have a Partograph

Women with problems which are identified before labour starts or during labour which need special attention

Starting a Partograph

ACTIVE PHASECONTRACTIONS: 1 or more /10minsCERVICAL DILATION: 4 cm

In the centre of Partograph is a Graph. Along the left side are numbers 0 -10 against squares. Each square represents 1cm dilatation.

At the bottom, each square represents 1hour

The dilatation of Cx is plotted with an X. Vaginal examinations are done at admission and once in 4 hours. Women, particularly multipara, may need to be checked morefrequently in advanced labour.

RUPTURED BAG OF WATER W/O CONTRACTION: > NO IE > monitor A.FIf there are SIGNS OF INFECTION, or the membranes have been RUPTURED 18 H or more, or the pregnancy is less than 37 weeks gestation with or without infection,

give antibiotics. Then arrange for transfer of the woman to a higher level health facility with special neonatal care facilities.

Uterine ContractionsThe squares below provide the key to recording the strength of contractions on the partograph.

Dots represent mild contractions of less than 20 seconds duration.

Diagonal lines indicate moderate contractions of 2040 seconds duration.

Solid color represents strong contractions of longer than 40 seconds duration.

The fetal condition Fetal heart rate

membranes and liquor (amniotic fluid)

moulding

Between Alert and Action Linesrehydrationemptying the bladderencouraging the woman to be more active and move aroundadopt an upright position assess after 2-4 hours

However, if there is any other complication (e.g. hypertension, fetal distress, failure of the head todescend, etc.), the mother must be referred immediately for expert help, unless the birth is imminent.