Evaluation of paperless partogram as a bedside tool in the management of labor

Agarwal, Kiran; Agarwal, Lata; Agrawal, VK; Agarwal, Ashok; Sharma, Mahender

doi:10.4103/2249-4863.109944

Cited by 11 publications

(16 citation statements)

References 10 publications

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“…This finding is in accordance with the recommendation of WHO plotting the action parallel 4 hours after the alert line [3] [4]. Such a timing of intervention was also put forth by Lavender et al [6] and Agarwal et al [12] who reported an average of 4.3 h (4.7 h for primiparous and 3.7 h for multiparous). In the present study we registered 32 cesarean sections (9%).…”

Section: Discussionsupporting

confidence: 89%

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Using Alert and Action Expected Times of Delivery in Prevention of Prolonged Labor

Tandu-Umba¹,

Muamba²

2015

OJOG

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Background and Objective: Although globally admitted as the most valuable tool to prevent prolongation of labor, the partogram has failed to be commonly used. This is due to its alleged complexity. Based on the simplified model proposed by Debdas, the so called paperless partogram, we aimed at evaluating the ability of only using the alert and action lines to prevent prolongation of labor. Methods: This was a cross-sectional study including labor records of women delivered at King Baudouin Hospital of Kinshasa (secondary level) from 01/01 till 31/12/2013. The study was approved by the Faculty Ethical Committee. Inclusion criteria were: 1) live singleton pregnancy, 2) cephalic fetal presentation, 3) lack of uterine scar, 4) monitoring in labor ward by 4 cm of cervical dilation, and 5) delivery at term. For every record, the expected time of delivery (ETD = 6 hours after 4 cm of cervical dilation) was considered "Alert EDT" to which 4 hours were added to obtain the "Action EDT". Irrespective of other fetal and maternal features contained in the traditional partogram Alert and Action ETD were checked a posteriori on Debdas's model to derive the appropriate outcome of labor. Results: The study included 357 participants, of which 219 primiparous and 138 multiparous. Vaginal delivery took place in 91% of cases. Full cervical dilation was achieved after 8-9 hours (9.5 ± 1.8 hours for primiparous and 8.4 ± 1.7 hours for multiparous women), namely 2-3 hours following Alert ETD). This duration is close to the Action ETD. For 32 cesarean sections (9%) final decision took place within the Alert ETD. Conclusion: Using only Alert and Action ETD was found convenient to derive appropriate measures for the outcome of labor. So, the paperless partogram is a simplified method to manage the active stage of labor that could prevent prolongation of labor in our setting.

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Section: Discussionsupporting

confidence: 89%

“…Agarwal et al [12] in India recruited 91 women, of which 13% of induced labor. In an experimental model, they monitored parturients on the basis of Alert estimated time of delivery (ETD) and Action ETD.…”

Section: Discussionmentioning

confidence: 99%

Using Alert and Action Expected Times of Delivery in Prevention of Prolonged Labor

Tandu-Umba¹,

Muamba²

2015

OJOG

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“…A study by Agarwal k et al in Uttar Pradesh observed a rate of 1% caesarean sections with the Paperless partograph. 8 Another study conducted by Fatouh E et al in Egypt from 1st March to last of August 2014 observed a CS rate of 23.1% with the Paperless partograph. 9 Thus the paperless partograph was found similar and effective in monitoring labour as compared to the WHO partograph.…”

Section: Discussionmentioning

confidence: 94%

The paperless partograph: can it be effective to replace the WHO modified partograph

Deka

Sharma

Das

2016

Int J Reprod Contracept Obstet Gynecol

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However the current problem is that the use and complete documentation of the Partograph is notoriously low in low resource countries. Several factors have been implicated to the cause of this low use such as lack of awareness and proper training, low availability of partographs, negative perceptions of the partograph, high patient load, inadequate staff at the facilities, lack of supervision, and negative attitudes among some of the health workers. 3 Continuous monitoring of labour and provision of rapid care to deal with problems are most crucial for preventing adverse obstetric outcomes related to childbirth. Debdas argues that the WHO partograph fails to meet the present requirements and proposes the Paperless partograph. The Paperless partograph is a simple, graph less, non-time consuming method which only involves the calculation of an expected time of ABSTRACT Background: The partograph is a graphical representation of the various events of labour plotted against time. The main aim was to determine whether the paperless partograph can replace the WHO partograph to monitor labour and aid in decision making. Methods: It is a hospital based prospective analytical study. The course of labour in 400 women with term singleton uncomplicated pregnancies were studied by using either partographs. 12 resident doctors were included to assess the user friendliness and asked to fill 240 separate partographs (120 each of WHO Modified and Paperless partograph). Results: The maternal and perinatal outcome was comparable between both the partographs. The Paperless partograph was however more user-friendly than the WHO partograph (p<0.0001). Conclusions:The Paperless partograph was found to be as effective as the WHO partograph in the effective management of labour. It is more user-friendly and has promising prospects to replace the WHO partograph.

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“…Study from India, Agarwal et al included 91 women, of which 13% was induced labor. 16 They monitored women in labour on the basis of Alert estimated time of delivery (ETD) and Action ETD. At the time of the Action ETD, if delivery had not yet occurred, a diagnosis of prolonged labour was made and arrangements were made for emergency caesarean section.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of user friendliness of paperless partogram compared to WHO partogram in preventing prolonged labour

Faswila¹,

Rao²

2018

Int J Reprod Contracept Obstet Gynecol

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Background: Partogram is being used since 1954 when Friedman described it for monitoring progress of labour. The Paperless Partogram proposed by Dr. Debdas is a low-skill method for detection of abnormal labour. The objective of the present study was to know efficacy and user friendliness of paperless partogram in comparison with WHO partogram in monitoring and management of labourMethods: It’s a comparative study. Total of 100 patients were included in the study where half of the patients were monitored by paperless partogram and the other half by WHO modified partogram. The plotting of the WHO partographs started as soon the cervical dilatation was 4 cm along with regular painful uterine contractions. In the paperless partogram calculation will be two times, an ALERT ETD (estimated time of delivery) and an ACTION ETD. The outcome of labour will be recorded at the end of each partographs.Results: Paperless partogram was better than WHO partogram in terms of documentation, ease of use, learning, time factor, cost effectiveness and monitoring of labour, identification of abnormal labour.Conclusions: In present study paperless partogram was found to be preferred for monitoring of labour.

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Evaluation of paperless partogram as a bedside tool in the management of labor

Cited by 11 publications

References 10 publications

Using Alert and Action Expected Times of Delivery in Prevention of Prolonged Labor

Using Alert and Action Expected Times of Delivery in Prevention of Prolonged Labor

The paperless partograph: can it be effective to replace the WHO modified partograph

Comparative study of user friendliness of paperless partogram compared to WHO partogram in preventing prolonged labour

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