The partograph case tz

OBG

1. The Partograph

3. Partograph
•Use partograph to monitor progress of
labour at all women admitted to labour
ward
•Women should not be admitted for labour
ward until in active labour
•Active labour is when women have regular
contractions (3-5 in ten minutes) and
cervix is 4 cm. dilated

4. Fetal Heart Rate:
•Assess after contraction for 60 seconds:
•Each 30 minutes in first stage (each 15
minutes if risk factors are identified
•Each 5 minutes when pushing

5. Cervical Dilatation
•Assessed each 4 hours (or before if a crossed
action line is anticipated)
Alert Line:
•Start recording cervical dilatation in the alert line.
•As long as dilatation is 1 cm or more/hr the alert
line is not crossed.
•If cervical dilatation is < 1 cm/hr the alert is
crossed and causes of prolonged labour should
be considered: always consider: artificial rupture
of membranes and augmentation with oxytocin.

6. Cervical dilatation
Action Line:
•If the action line is crossed the actions
should be as follows in mentioned order (if
not already performed)
•ARM and oxytocin augmentation
•Correction of malposition
•Cesarean Section or Vacuum (if in second
stage and descend is 1/5 or below)

7. Amniotic fluid:
I= Intact Membranes
C= Clear
M= Meconium stained
B= Blood stained
Remember: the diagnosis
“cephalopelvic disproportion” cannot
be made with intact membranes!

8. Contractions:
Chart every 30 minutes
Number/10 minutes and Duration
•Weak: Lasting <20 seconds Medium:
Lasting 20-40 seconds Strong: Lasting
>40 seconds
Oxytocin:
•Record oxytocin (amount/volume) and
drops / minute