Partograph

partograph , cervicograph , components of partograph , advantages of a partograph

1. PARTOGRAPH - DR. SUPRIYA MAHIND

2. Partograph is a composite graphical record of key data (maternal and fetal) during labor, entered against time on a single sheet of paper. In cervicograph , the alert line starts at 4 cm (WHO) of cervical dilatation and ends at 10 cm dilatation (at the rate of 1 cm/hr ) The action line is drawn 4 hours to the right and parallel to the alert line. In a normal labor, the cervicograph (cervical dilatation) should be either on the alert line or to the left of it. PARTOGRAPH

3. Partographic analysis of labor to detect types of prolonged labor—protracted latent phase, protracted active phase and secondary arrest

4. Cervicograph showing slow (protracted) cervical dilatation and descent of the presenting part. Oxytocin infusion was started following amniotomy. Partograph showed arrest in the progress in spite of adequate contractions. Labor was terminated by cesarean section

5. When it falls on Zone 2 it is abnormal and need to be critically assessed. When it falls in Zone 3 case should be reassessed by a senior person . Decision is to be made either for termination of labor (cesarean section) or for augmentation of labor ( amniotomy and or oxytocin).

6. Patient identification Time — recorded at hourly interval . Zero time for spontaneous labor is the time of admission in the labor ward and for induced labor is the time of induction Fetal heart rate — recorded at every 30 minutes State of membranes and color of liquor : to mark ‘I’ for intact membranes, ‘C’ for clear and ‘M’ for meconium stained liquor Cervical dilatation and descent of the head . THE COMPONENTS OF PARTOGRAPH

7. f) Uterine contractions — the squares in the vertical columns are shaded according to duration and intensity . (g) Drugs and fluids (h) Blood pressure (recorded in vertical line) at every 2 hours and pulse at every 30 minutes ( i)Oxytocin — concentration in the upper box and dose (m IU/min) in the lower box

8. (j) Urine analysis (k) Temperature record

9. Advantages of a partograph: ( i) A single sheet of paper can provide details of necessary information at a glance; ( ii) No need to record labor events repeatedly ; (iii) It can predict deviation from normal progress of labor early. So, appropriate steps could be taken in time ( iv) It facilitates handover procedure ; ( v) Introduction of partograph in the management of labor ( WHO 1994) has reduced the incidence of prolonged labor and cesarean section rate. There is improvement in maternal morbidity, perinatal morbidity and mortality.

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