Comparative study of user friendliness of paperless partogram compared to WHO partogram in preventing prolonged labour

Faswila M., Smitha B. Rao


Background: Partogram is being used since 1954 when Friedman described it for monitoring progress of labour. The Paperless Partogram proposed by Dr. Debdas is a low-skill method for detection of abnormal labour. The objective of the present study was to know efficacy and user friendliness of paperless partogram in comparison with WHO partogram in monitoring and management of labour

Methods: It’s a comparative study. Total of 100 patients were included in the study where half of the patients were monitored by paperless partogram and the other half by WHO modified partogram. The plotting of the WHO partographs started as soon the cervical dilatation was 4 cm along with regular painful uterine contractions. In the paperless partogram calculation will be two times, an ALERT ETD (estimated time of delivery) and an ACTION ETD. The outcome of labour will be recorded at the end of each partographs.

Results: Paperless partogram was better than WHO partogram in terms of documentation, ease of use, learning, time factor, cost effectiveness and monitoring of labour, identification of abnormal labour.

Conclusions: In present study paperless partogram was found to be preferred for monitoring of labour.


Labour monitoring, Modified WHO partogram, Paperless partogram

Full Text:



Maternal mortality. World Health Organization. Available from:

Friedman E. The graphic analysis of labor. Am J Obstet Gynecol. 1954;68(6):1568-75.

Philpott RH. Graphic records in labour. Br Med J. 1972;4(5833):163-5.

Philpott RH, Castle WM. Cervicographs in the management of labour in primigravidae. I. The alert line for detecting abnormal labour. J Obstet Gynaecol Br Commonw. 1972;79(7):592-8.

Philpott RH, Castle WM. Cervicographs in the management of labour in primigravidae. II. The action line and treatment of abnormal labour. J Obstet Gynaecol Br Commonw. 1972;79(7):599-602.

Fatusi AO, Makinde ON, Adeyemi AB, Orji EO, Onwudiegwu U. Evaluation of health workers’ training in use of the partogram. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 2008;100(1):41-4.

Lavender T, Hart A, Smyth RM. Effect of partogram use on outcomes for women in spontaneous labour at term. Cochrane Database Syst Rev. 2012;8:CD005461.

Mathews JE, Rajaratnam A, George A, Mathai M. Comparison of two World Health Organization partographs. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 2007;96(2):147–50.

World Health Organization, International Confederation of Midwives, editors. Education material for teachers of midwifery: midwifery education modules. 2nd ed. Geneva [Switzerland]: World Health Organization: International Confederation of Midwives; 2008.

Ogwang S, Karyabakabo Z, Rutebemberwa E. Assessment of partogram use during labour in Rujumbura Health Sub District, Rukungiri District, Uganda. Afr Health Sci. 2009;9(1):S27.

Cartmill RSV, Thornton JG. Effect of presentation of partogram information on obstetric decision-making. Int J Gynecol Obstet. 1993;40(2):1520-2.

Lavender T, Alfirevic Z, Walkinshaw S. Partogram action line study: a randomised trial. Br J Obstet Gynaecol. 1998;105(9):976-80.

Tay S-K, Yong T-T. Visual Effect of Partogram Designs on the Management and Outcome of Labour. Aust N Z J Obstet Gynaecol. 1996;36(4):395-400.

World Health Organization partograph in management of labour. World Health Organization Maternal Health and Safe Motherhood Programme. Lancet Lond Engl. 1994;343(8910):1399-404.

Fatouh E, Ramadan S. Effect of Using Paperless Partogram on the Management and Outcome of Labour and the Nurses’ Opinion. J Educ Pract. 2015;6(8):17-23.

Agarwal K, Agarwal L, Agrawal VK, Agarwal A, Sharma M. Evaluation of paperless partogram as a bedside tool in the management of labor. J Fam Med Prim Care. 2013;2(1):47-9.