PARTOGRAM- MATERNAL AND FETAL MONITORING

ASSOCIATE PROFESSOR

1. Partogram –maternal and fetal monitoring

2. Defnition The partograph is a graphic representation used to assess the progress of labor and to identify when intervention is necessary.

3. A partograph is used to record all observations made on a woman in labour . The central feature of this is , graph, where dilatation of the cervix is plotted by assessing the vaginal examination. By noting the rate of cervical dilatation , it is possible to identify women whose labours are abnormally slow and who require special attention. The partograph is used to plot following parameters for the progress of labour; cervical dilatation , descent of the fetal , and uterine contractions .

4. It is also used for monitoring fetal conditions with the following parameters fetal heart rate , membranes and liquor and moulding of fetal skull. Additionally , the partograph can be used to monitor maternal conditions – pulse , blood pressure, temperature, urine, drugs, IV fluids, and oxytocin . Vaginal examination is generally done every 2-4 hours . Uterine activity and the heart rate of fetus is assessed every 15minutes . The findings are recorded on the graph.

5. Benefits of using the partograph Effective means of recording progress of labour. Transfer of information becomes easy when labor status normal. Provides the opportunity for early identification of deviations from normal. It serves as a visual means of recording all observations and includes a pictorial record of the rate of cervical dilatation. It saves the timing of the staff, which can be wasted in long writings.

6. It is the diagramatic representation of the dilatation of the cervix charted against the hours in labour During the first stage of labour, monitoring of mother and fetus is very important to assure the well being of both. There are some significant factors which should be considered during this period. Urine testing of the mother is done for gulcose , proteins, and ketones . Vital signs of the mother are assessed at regular intervals. Pulse rate can be increased during this stage. Increased metabolism may lead to increase in respiration . During contractions, blood pressure also increased.

7. One should look for bladder distention . A distended bladder can cause obstruction in labour. So, the bladder must emptied every 2-3 minutes . Mother may feel tired exhausted. Her general condition should be monitored to look for signs of fatigue . Gastric empting is prolonged during this period . So, hydration should be maintained by fluids . Fetal lie, presentation, position and attitude should be assessed. Fetal heart rate also be monitored regularly, either externally (by electronic monitoring) or internally (by scalp electrodes).

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9. BIBLIOGRAPHY Adele Pillitteri (2003), ‘’ Maternal child health nursing care of child bearing sand child rearing family ’’ , 5th edition, Philadelphia: Lippincott company. P.no28-30. Burns, M.Gravew S.K (1999), “ Understanding nursing research, ” 3rd edition, W.B Saunders publication, London. P.no56-59. Christopher. J. Carey and Rayburn (1996), “ Text book of Obstetric and Gynecology, ” 3 rd edition, New Delhi : Warvey Pvt. Ltd. P.no74- 78. Bobak . Jenson (1995), “ Maternity and gynaecology care, ” 3rd edition, Miscoure Mosby company. P.no875. Corinne. H. (1986), “ Normal and therapeutic nutrition, ” 7th edition, Mac Millian . P.no187-190.

10. THANK YOU