Partograph.pptx

Partograph during 1 stage of labour

1. PARTOGRAPH PRESENTED BY – PREETI KUlsHRESTHA M.SC. NURSING pREVIOUS YEAR

2. DEFINITION It is a composite graphical recording of cervical dilatation and descent of head against duration of labour in hours. It also gives information about fetal and maternal condition that are all recorded on single sheet of paper.

3. Principles of partograph The active phase of labour commence at 4 cm cervical dilatation. The latent phase of labour should not last longer than 8 hrs. During active labour, the rate of cervical dilatation should not be slower then 1cm/ hr. Every 4 hrs. vagial examination is recommended.

4. Alert line and action line

5. partograph Old partograph New partograph

6. Use of partograph Patients information : Fill out name Gravida Para Hospital no. Date and time of admission Time of ruptured membrane hours

7. CONTD. Fetal heart rate : The rate of the fetal heart rate indicates the state of the fetus inside the uterus . Record every half hrs. 180bpm = tachycardia 160bpm = bradycardia 100bpm = severe bradycardia

8. contd . Amniotic fluid : record the colour of amniotic fluid at every vaginal examination – I = membranes intact R = membranes ruptured, clear fluid M = meconium-stained fluid B = blood-stained fluid A = absent amniotic fluid

9. CONTD. moulding : is a state of reduction or loss of space between skull bones. Recording of degree of moulding = Separated bones, sutures felt easily – 0 Bones just touching each other – +1 Overlapping bones – +2 Severely overlapping bones – +3

10. CONTD. (A)Cervical dilatation : Assessed at every vaginal examination and marked with a cross (x). Begin plotting on the partograph at 4 cm. This graph consists of homogenous squares, 10 square vertically , each square indicate 1 cm of cervical dilatation.

11. CONTD. (B) Decent of the head : this is assessed by abdominal examination before doing vaginal examination. Refers to the part of the head palpable above the symphysis pubis. Recorded as circle (o) at every vaginal examination.

12. CONTD. Uterine contractions : Uterine contraction are recorded graphically on the partograph according to their strength and frequency. Observation of contraction is made half hourly in the active phase. Palpate the no. of contractions in 10 mins and their duration in sec.

13. CONTD. Oxytocin drip : This consists of two line, one for the record of unit of oxytocin per litter of iv fluid and other one is for drop of fluid per min. The recording can be made at the interval of 30 mins. As the uterine contraction.

14. CONTD. Drugs and iv fluids : Record any additional drug given and are recorded at the particular point of time. This includes sedatives, antibiotics , iv fluids etc. The name of the drugs does given should be written in the long box.

15. CONTD. Maternal condition : Pulse – record every 30 mins and mark with a dot (.) B.P. – record every 4 hrs and mark with arrows. Temperature – record every 2 hrs.

16. CONTD. Urine analysis : During the course of labour, the examination of urine is important. In case of maternal distress the volume of urine may decrease and it may contain ketone bodies.

17. Thank you