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

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