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

Abstract

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.

Utility of paperless partogram in labor management

“…23 Perinatal outcome were similar in both groups in terms of baby weight which was found to be 2.90 kg in Group A and 2.91 kg in Group B. this result is in concordance to study of Deka G et al, where mean baby weight in paperless group was 2.7 kg and WHO modified partograph was also 2.7 kg. 22 From our result we found that most patients follow a normal delivery course and both paperless partogram and WHO modified partograph was effective in management of labor and gave similar result on maternal and fetal parameter and outcome. Thus, introduction of paperless partogram for monitoring labor can be very promising as simple easy and cast effective bedside tool.…”

“…21 Other studies with results similar were Deka G et al, where 83% in Group A delivered before ETD and 77% in Group B delivered before alert line. 22 Veena L et al, also saw that patient followed normal course of delivery and delivered before alert ETD in 83% in Group A and 77% in Group B. 23 Most of patient i.e.…”

“…This result is similar with study conducted by Deka G et al, were spontaneous vaginal delivery was found to be 88.5% in Group A and 85% in Group B women. 22 Veena L et al, found that there was 85% spontaneous vaginal delivery in paperless group and 79% in women followed by WHO modified partograph. 23 Perinatal outcome were similar in both groups in terms of baby weight which was found to be 2.90 kg in Group A and 2.91 kg in Group B. this result is in concordance to study of Deka G et al, where mean baby weight in paperless group was 2.7 kg and WHO modified partograph was also 2.7 kg.…”

Study to compare between paperless partogram and modified who partogram in management of labour

“…But there was no difference in overall usefulness score between the two groups. 7 Even though there was no much difference in the monitoring and management of labour between the two preferred modes of partogram by all residents was paperless i.e.5 out of 6 (83.3%) residents preferred paperless partogram. Similar results were observed in a study conducted by Fatouh E et al in Egypt in 2014 with the Paperless partograph where most of the nurses (75%) preferred to use the paperless partograph over the traditional WHO partograph in the management of labour.…”

Feasibility and effectiveness of electronic vs. paper partograph on improving birth outcomes: A prospective crossover study design

“…Similar findings have also been observed with the paperless partograph used in other country contexts. Deka G et al reported that C-section rate was 10% with the WHO paper partograph while it reduced to 6% with the paperless partograph [34]. C-section deliveries, as a component of emergency obstetric care was designed to save maternal and fetal lives when the delivery course gets complicated and under certain clinical conditions.…”