The Impact of Use of Modified Who Partograph on Maternal and Perinatal Outcome

Abstract

Background: Early detection of abnormal progress and prevention of prolonged labour can significantly improve the outcome of labour. Partograph is an inexpensive tool which can provide a continuous pictorial overview of labour and is essential to monitor and manage labour. Objective: The study was aimed to determine if among low risk labouring women, the use of modified WHO partograph resulted in reduced maternal and perinatal morbidity Methodology: The course of labour of 100 women with uncomplicated full term pregnancies with cephalic presentation in active labour was studied using modified WHO partograph. 100 historical matched controls comprising of low risk women who delivered without the use of partograph were identified from the labour register and their course of labour studied. The hospital records were studied to obtain the demographic variables. Maternal and perinatal outcome was analyzed for both cases and controls. Results: The emergency caesarean section rate was reduced from 44% in controls to 21% in cases (p value <0.05). None of the cases had labour beyond 12 hours, thus indicating significant reduction in prolonged labour. Neonatal intensive care admissions decreased from 17% in controls to 6% in cases indicating an improved maternal & neonatal outcome. Conclusion:The use of Modified WHO Partograph significantly improves the maternal and neonatal outcome of labour thus recommending use of WHO partograph in all maternity units.

Partograph Utilization and Factors Associated with Poor Perinatal Outcomes in Wolaita Sodo University Referral Hospital, Southern Ethiopia

“…In present study, the various parameters recorded to substandard ranged from 5-60% of the cases, with the lowest recording of maternal urine output. It is higher than the study done in Ghana (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35).5%) [15] and Kenya, most of parameters [16]. On the other hand, the study conducted in Tanzania was 86% of the cases recorded to substandard [18], which is higher than this findings.…”

Partograph versus no partograph: effect on labour progress and delivery outcome: a comparative study

“…The present study was comparable to the study conducted by Surekha T et al who found a significant reduction in NICU admissions of control group not monitored by Partograph (17%) as compared to the cases (6%) who were monitored by modified WHO Partograph. 12 In study conducted by Ajay KS et al, there were 5.2% NICU admissions.…”

A realist review of the partograph: when and how does it work for labour monitoring?

“…However, evidence from other studies indicates that partograph use may contribute to shorter labours and some improvement in maternal and fetal outcomes [18–21]. Health care workers found the modified partograph the most user-friendly version [3, 22, 23], with the latent phase of the composite partograph considered difficult to complete.…”

“…In terms of improved outcomes for women and newborns, there is conflicting evidence as to whether the partograph works, although studies in low-resource settings suggest that it may have positive impact [18–21]. There is no evidence that partograph use is detrimental to outcomes [2].…”

“…There is no evidence that partograph use is detrimental to outcomes [2]. Whilst there is no data related to maternal satisfaction or quality of care when the partograph is used, suggestions of fewer vaginal examinations, reduced length of labour and referral may indicate that women are receiving more appropriate treatment and intervention [18–21, 37]. …”