The Partograph

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The Partograph
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Partograph

• Use partograph to monitor progress of labour at
  all women admitted to labour ward
• Women should not be admitted for labour ward
  until in active labour
• Active labour is when women have regular
  contractions (3-5 in ten minutes) and cervix is 4
  cm. dilated

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Fetal Heart Rate

• Assess after contraction for 60 seconds
• Each 30 minutes in first stage (each 15 minutes
  if risk factors are identified
• Each 5 minutes when pushing

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Cervical Dilatation

• Assessed each 4 hours (or before if a crossed
  action line is anticipated)
• Alert Line
• Start recording cervical dilatation in the alert
  line.
• As long as dilatation is 1 cm or more/hr the
  alert line is not crossed.
• If cervical dilatation is lt 1 cm/hr the alert is
  crossed and causes of prolonged labour should be
  considered always consider artificial rupture
  of membranes and augmentation with oxytocin.

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Cervical dilatation

• Action Line
• If the action line is crossed the actions should
  be as follows in mentioned order (if not already
  performed)
• ARM and oxytocin augmentation
• Correction of malposition
• Cesarean Section or Vacuum (if in second stage
  and descend is 1/5 or below)

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Amniotic fluid

• I Intact Membranes
• C Clear
• M Meconium stained
• B Blood stained
• Remember the diagnosis cephalopelvic
  disproportion cannot be made with intact
  membranes!

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Contractions

• Chart every 30 minutes
• Number/10 minutes and Duration
• Weak Lasting lt20 seconds Medium Lasting 20-40
  seconds Strong Lasting gt40 seconds
• Oxytocin
• Record oxytocin (amount/volume) and drops / minute

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