Partogram
- Partogram is a graphical representation of the progress of labour depicting cervical dilatation and station of head plotted against time
- The concept of partogram was first introduced by Friedman
Data recorded in a partogram are:
- Patient data – Name, Age, Parity, Hospital identification number, Date of admission, Time of admission
- Dilatation of cervix
- Station of fetal head
- Fetal heart rate
- Number of uterine contractions in 10 minutes
- Moulding (+ / ++ )
- Liquor amni
- Intact membranes – I
- Clear liquor – C
- Meconium staining – M
- Oxytocin units, drops/min
- Drugs
- Oral and IV fluids
- Blood pressure, pulse, temperature
- Urine for acetone
How to use a partogram in active management of labour:
- Labour is divided into 2 stages
- Latent phase – from onset of true labour pains till 3 cm dilatation of cervix
- Active phase – 3 cm dilation of cervix till complete dilatation (10cm)
- Once labour is in active phase, cervical dilation is expected to progress at the rate of at least 1cm per hour
- This minimum rate is plotted as alert line on the partogram
- Another line – alert line – is plotted 4 hours to the right
- As long as the plotted cervical dilatation curve is to the left of the alert line, it is considered normal
- If the curve crosses the alert line, intervention is necessary – if the patient is in a peripheral hospital, referral to a higher level hospital is necessary
Advantages of using a partogram:
- All the data regarding the progress of labour can be understood at a glance from the partogram
- It is necessary for active management of labour
- Decreases incidence of prolonged labour and caesarean section.
- Reduces maternal mortality and morbidity