Study of partogram in relation to labour outcome and significance of alert line in partogram

Authors

  • Vineeta Ghanghoriya Department of Obstetrics and Gynecology, NSCB MCH, Jabalpur, Madhya Pradesh, India
  • Kirti Patel Department of Obstetrics and Gynecology, NSCB MCH, Jabalpur, Madhya Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20180997

Keywords:

Action line, Alert line, Partogram, Labour

Abstract

Background: The partogram is a simple, inexpensive tool to provide a continuous pictorial overview of labor. The goal of this study is to use partograph to monitor labor, initiate uterine activity that is sufficient to produce cervical changes, fetal descent while avoiding uterine hyperstimulation, hypostimulation and fetal distress and provide timely surgical intervention where required.

Methods: Total 200 term patients, both primigravida and multigravida were selected for study and partograph recording were commenced at 4 cm dilation close maternal and fetal monitoring was done throughout the labour and partogram was plotted to detect any deviation from normal course.

Results: Patients were grouped into primigravida and multigravida and based on partogram finding divided into delivered “before alert line” and “between alert and action line” and after action line.175 women delivered vaginally, out of this 106 delivered before alert line ,83 between alert line and action line and 11 after crossing action line.

Conclusions: Partographic management of labour is a time honored and evidence based scientific way of managing labour. Partograph improves the quality of delivery care, since it permits to identify dystocia and make logical and effective interventions. It reduces unnecessary strain on mothers by reducing total duration of labour, without any increased foetal morbidity and mortality.

References

Levin K, Kabagema Jd A. Use of the partograph: effectiveness, training, modifications, and barriers: a literature review. Washington, DC, United States Agency for International Development, Fistula Care, Engender Health. 2011; 28.

WHO: World health organization maternal health and safe motherhood programme. Lancet. 1994;343:1399-1404.

World Health Organization: Pregnancy, childbirth, postpartum and newborn care: a guide for essential practice. Geneva: World Health Organization;2006.

World Health Organization: Managing complications in pregnancy and childbirth. Geneva: World Health Organization;2000.

Magon N. Partograph revisited. Int J Clin Cases Investig. 2011;3(1):1-6.

Friedman EA. Primigravida labour: a graphicostatistical analysis. Obstet Gynecol. 1955;6:569.

Philpott RH, Castle WM. Cervicographs in the management of labour - the alert line for detecting abnormal labour. J Obstet Gynecol British Commonwealth. 1972;79:599-602.

Philpott RH, Castle WM. Cervicographs in the management of labour- the action line for detecting abnormal labour. J Obstet Gynecol British Commonwealth. 1972:79.

WHO. World Health Organization Partogram in management of labour. The Lancet. 1994:1399-404.

WHO. Training modules 11. The use of the Partograph (also known as Partogram). Essential Antenatal, Perinatal and Postpartum Care Copenhagen: World Health Organisation.2002:184-94.

Opoku BK, Nguah SB. Utilization of the modified WHO partograph in assessing the progress of labour in a metropolitan area in Ghana. Res J Womens Health. 2015 May;2(1):2.

Studd J, Clegg DR, Sanders RR, Hughes AO. Identification of high risk labours by labour nomogram. Br Med J. 1975 Jun 7;2(5970):545-7.

Studd JWW. Partograms and normograms in the management of primigravida labour. Br Med J. 1973;4:451-5.

Hendricks CH, Brenner WE, Kraus G. Normal cervical dilatation pattern in late pregnancy and labor. Am J Obstet Gynecol. 1970;106(7):1065-82.

Beazley JM, Kurjak A. Influence of a partograph on the active management of labour. Lancet. 1972;2(7773):348-51.

Lavender T, Alfirevic Z, Walkinshaw S. Effect of different partogram action lines on birth outcome: A randomized controlled trial. Obstet Gynecol. 2006;108:295-302.

Manjulatha VR, Anitha GS, Shivalingaiah N. Partogram: clinical study to assess the role of Partogram in primigravidae in labor. Int J Reprod Contracept Obstet Gynecol. 2016 Dec;5(4):1014-25.

Frigoletto Jr FD, Lieberman E, Lang JM, Cohen A, Barss V, Ringer S et al. Clinical trial of active management of labor. N Engl J Med. 1995;333:745-50.

Pattinson RC, Howarth GR, Mdluli W, Macdonald AP, Makin JD, Funk M. Aggressive or expectant management of labor: A randomized clinical trial. Obstet Gynecol Surv. 2003 Nov;58(11):708-10.

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Published

2018-03-27

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Original Research Articles