Usage of who modified partogram for term primigravidae

Abstract

A partograph is a composite graphical record, of progress of labour and silent condition of mother and foetus the partograph was not created for the convenience of doctors; infact it was created as a tool for all health professionals including midwives and traditional birth attendants. It serves as an early warning system and assists in early decision on transfer, augmentation and termination of labour. In under resourced setting, prolonged labour and delay in decision-making and late referrals are important causes of adverse obstetric outcome owing to resource constraints in such settings, it is usually not possible to monitor each woman continuously throughout the duration of the labour. In such setting, the partograph serves a simple and inexpensive tool to monitor labour in a cost-effective way. Thus labour a simple natural process which can take a turn making it lethal for any patient. The role of obstetric caregiver is to avoid unnecessary intervention in this natural physiological process but at the same time to identify problems when things start going amiss. so the early recognition of any deviation from normal progression of labour will help to prevent or reduce undesirous maternal and fetal outcome, which brings in the importance of partogram Aim 1) To recognise abnormal labour at an early stage using WHO partogram in relation to the alert line and action line. 2) To evaluate the role of partogram in preventing prolonged labour 3) Toasses the maternal and perinatal morbidity and mortality. Materials and Methods Study design: comparative prospective clinical study No of cases: 200 cases each at term in labour Sampling technique: Random selection of subjects meeting the inclusion and exclusion criteria. The WHO modified partogram is attached to the mothers case record when the patient is admitted in the labour room. Labour in 200 patients (control group) is monitored without using partogram. Outcomes are stratified in terms of duration of labour, mode of delivery, maternal and neonatal outcome. Results  The mean duration of first stage labour-9.6 hours  The mean duration of second stage of labour-21.77 minutes  The mean total duration of labour-10.2 hours  Lscs-60% in control, 40% in test group. Conclusion 1. Abnormal labour patterns can be identified earlier by partogram. 2. The difference in outcomes like mode of delivery, augmentation of labour and neonatal outcome was significant and can be predicted by partogram. 3. Maternal and perinatal outcomes can be predicted with use of partogram.