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Partograph exercises
 

Partograph exercises

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    Partograph exercises Partograph exercises Presentation Transcript

    • 1Maternal and Newborn Health Unit Liverpool School of Tropical MedicineLSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn CareUsual frequency of examinationVaginal examination 4 hourlyFetal Heart Rate ½ - ¼ hourlyMouldingSutures apposed +Sutures overlapped but reducible 2+Sutures overlapped but not reducible 3+SymbolsCervix xHead OBreech wFetal heart rate .Descent: Abdominal palpation1Descent: Abdominal palpation1Amniotic fluidMembranes intact IMembranes ruptures, clear fluid CMeconium stained fluid MBlood stained fluid B1. WHO Managing complications in pregnancy and childbirth
    • 1. What actions will you take?2. How will you look after this woman?QuestionsPartograph Case 1Partograph Case 1Maternal and Newborn Health Unit Liverpool School of Tropical MedicineLSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn CareName: Mrs KAHospital No.: 462432 XYAge (Years): 20Parity: Para 0 +0Gestational age(Weeks):38TimeCervix(cm)Membranes/LiquorLie PresentationFHR(/Min.)Moulding DescentContractions(/10 Min.)9am 2cm Intact longitudinal Cephalic 140 o 5/52 (<20seconds)History•Lower abdominal pains•No drainage of liquorTime 9amPulse rate (/Min.) 90Blood pressure(mmHg)120/80Temperature (oC) 37.1o
    • 1. What actions will you take at 4pm?QuestionsPartograph Case 2Partograph Case 2Maternal and Newborn Health Unit Liverpool School of Tropical MedicineLSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn CareName: Mrs ADHospital No.: 462432 XYAge (Years): 18Parity: Para 2+0Gestational age (Weeks): 38TimeCervix(cm)Membranes/LiquorLie PresentationFHR(/Min.)Moulding DescentContractions(/10 Min.)4pm 4cm Intact longitudinal Cephalic 144 0 3/5 3 (35sec. each)8pm 8cm clear longitudinal Cephalic 146 0 2/5 4 (45 sec. each)History•Lower abdominal pains for 2 hours•Drainage of liquor for 1 hourTime 4pm 8pmPulse rate (/Min.) 88 90Blood pressure (mmHg) 120/70 120/70Temperature (oC) 37o37o
    • 1. What actions will you take at 4pm?2. What actions will you take at 8pm?QuestionsPartograph Case 2Partograph Case 2Maternal and Newborn Health Unit Liverpool School of Tropical MedicineLSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn CareName: Mrs ADHospital No.: 462432 XYAge (Years): 18Parity: Para 2+0Gestational age (Weeks): 38TimeCervix(cm)Membranes/LiquorLie PresentationFHR(/Min.)Moulding DescentContractions(/10 Min.)4pm 4cm Intact longitudinal Cephalic 144 0 3/5 3 (35sec. each)8pm 8cm clear longitudinal Cephalic 146 0 2/5 4 (45 sec. each)History•Lower abdominal pains for 2 hours•Drainage of liquor for 1 hourTime 4pm 8pmPulse rate (/Min.) 88 90Blood pressure (mmHg) 120/70 120/70Temperature (oC) 37o37o
    • Questions 1. What actions are required? 2. When would the next examination be?Partograph Case 3Partograph Case 3Maternal and Newborn Health Unit Liverpool School of Tropical MedicineLSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn CareName: Mrs DGHospital No.: 462432 XYAge (Years): 19Parity: Para 0 +1Gestational age (Weeks): 38TimeCervix(cm)Membranes/LiquorLie PresentationFHR(/Min.)Moulding DescentContractions(/10 Min.)6am 5cmIntactmembraneslongitudinal Cephalic 140 0 4/5 3 (40sec. each)10am 5cmArtificialrupture ofmembranes:clearlongitudinal Cephalic146 0 3/5 2 (20sec. each)12pm (noon) 8cm clear longitudinalCephalic140 0 2/5 2 (10 sec. each)2pm 9cm clearlongitudinal Cephalic144 0 2/5 2 (20 sec. each)History•Lower abdominal pains for 10 hours•No drainage of liqourTime 6am 10am 12pm 2pmPulse rate (/Min.) 80 84 88 92Blood pressure (mmHg) 130/70 130/70 140/70 140/70Temperature (oC) 37.3o37 37.5 37.5
    • Questions 1. Comment on the partograph. What actions are required? 2. When would the next examination be?Partograph Case 3Partograph Case 3Maternal and Newborn Health Unit Liverpool School of Tropical MedicineLSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn CareName: Mrs DGHospital No.: 462432 XYAge (Years): 19Parity: Para 0 +1Gestational age (Weeks): 38TimeCervix(cm)Membranes/LiquorLie PresentationFHR(/Min.)Moulding DescentContractions(/10 Min.)6am 5cmIntactmembraneslongitudinal Cephalic 140 0 4/5 3 (40sec. each)10am 5cmArtificialrupture ofmembranes:clearlongitudinal Cephalic146 0 3/5 2 (20sec. each)12pm (noon) 8cm clear longitudinalCephalic140 0 2/5 2 (10 sec. each)2pm 9cm clearlongitudinal Cephalic144 0 2/5 2 (20 sec. each)History•Lower abdominal pains for 10 hours•No drainage of liqourTime 6am 10am 12pm 2pmPulse rate (/Min.) 80 84 88 92Blood pressure (mmHg) 130/70 130/70 140/70 140/70Temperature (oC) 37.3o37 37.5 37.5
    • Questions 1. Comment on the partograph. What actions are required? 2. When would the next examination be?Partograph Case 3Partograph Case 3Maternal and Newborn Health Unit Liverpool School of Tropical MedicineLSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn CareName: Mrs DGHospital No.: 462432 XYAge (Years): 19Parity: Para 0 +1Gestational age (Weeks): 38TimeCervix(cm)Membranes/LiquorLie PresentationFHR(/Min.)Moulding DescentContractions(/10 Min.)6am 5cmIntactmembraneslongitudinal Cephalic 140 0 4/5 3 (40sec. each)10am 5cmArtificialrupture ofmembranes:clearlongitudinal Cephalic146 0 3/5 2 (20sec. each)12pm (noon) 8cm clear longitudinalCephalic140 0 2/5 2 (10 sec. each)2pm 9cm clearlongitudinal Cephalic144 0 2/5 2 (20 sec. each)History•Lower abdominal pains for 10 hours•No drainage of liqourTime 6am 10am 12pm 2pmPulse rate (/Min.) 80 84 88 92Blood pressure (mmHg) 130/70 130/70 140/70 140/70Temperature (oC) 37.3o37 37.5 37.5
    • Questions 1. Comment on the partograph. What actions are required?Partograph Case 3Partograph Case 3Maternal and Newborn Health Unit Liverpool School of Tropical MedicineLSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn CareName: Mrs DGHospital No.: 462432 XYAge (Years): 19Parity: Para 0 +1Gestational age (Weeks): 38TimeCervix(cm)Membranes/LiquorLie PresentationFHR(/Min.)Moulding DescentContractions(/10 Min.)6am 5cmIntactmembraneslongitudinal Cephalic 140 0 4/5 3 (40sec. each)10am 5cmArtificialrupture ofmembranes:clearlongitudinal Cephalic146 0 3/5 2 (20sec. each)12pm (noon) 8cm clear longitudinalCephalic140 0 2/5 2 (10 sec. each)2pm 9cm clearlongitudinal Cephalic144 0 2/5 2 (20 sec. each)History•Lower abdominal pains for 10 hours•No drainage of liqourTime 6am 10am 12pm 2pmPulse rate (/Min.) 80 84 88 92Blood pressure (mmHg) 130/70 130/70 140/70 140/70Temperature (oC) 37.3o37 37.5 37.5
    • 1. Plot the information on a partograph.2. What action will you take?3. When would you perform the next vaginal examination?QuestionsPartograph Case 4Partograph Case 4Maternal and Newborn Health Unit Liverpool School of Tropical MedicineLSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn CareName: Mrs HAHospital No.: 462432 XYAge (Years): 16Parity: Para 0 + 0Gestational age (Weeks): 39Time Cervix(cm)Membranes/LiquorLie Presentation FHR (/Min.) Moulding Descent Contractions(/10 Min.)10am 4cmSpontaneousrupture, clearLCephalic150 1 + 3/5 3 (30 sec. each)2pm 6cm Blood stained L Cephalic 156 2 + 3/5 4 (40 sec. each)4pm 6cm Meconium stained L Cephalic 164 3 + 3/5 4 (45 sec. each)History•Labour at home for 6 hours•Membrane ruptured 4 hours before admissionTime 10am 2pm 4pmPulse rate (/Min.) 80 86 92Blood pressure (mmHg) 120/70 130/70 130/70Temperature (oC) 37 37.2 37.2
    • 1. Comment on the partograph2. When would you perform the next vaginal examination?QuestionsPartograph Case 4Partograph Case 4Maternal and Newborn Health Unit Liverpool School of Tropical MedicineLSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn CareName: Mrs HAHospital No.: 462432 XYAge (Years): 16Parity: Para 0 + 0Gestational age (Weeks): 39Time Cervix(cm)Membranes/LiquorLie Presentation FHR (/Min.) Moulding Descent Contractions(/10 Min.)10am 4cmSpontaneousrupture, clearLCephalic150 1 + 3/5 3 (30 sec. each)2pm 6cm Blood stained L Cephalic 156 2 + 3/5 4 (40 sec. each)4pm 6cm Meconium stained L Cephalic 164 3 + 3/5 4 (45 sec. each)History•Labour at home for 6 hours•Membrane ruptured 4 hours before admissionTime 10am 2pm 4pmPulse rate (/Min.) 80 86 92Blood pressure (mmHg) 120/70 130/70 130/70Temperature (oC) 37 37.2 37.2
    • 1. Comment on the partograph.2. What action will you take in a BEOC and CEOC health facilityQuestionsPartograph Case 4Partograph Case 4Maternal and Newborn Health Unit Liverpool School of Tropical MedicineLSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn CareName: Mrs HAHospital No.: 462432 XYAge (Years): 16Parity: Para 0 + 0Gestational age (Weeks): 39Time Cervix(cm)Membranes/LiquorLie Presentation FHR (/Min.) Moulding Descent Contractions(/10 Min.)10am 4cmSpontaneousrupture, clearLCephalic150 1 + 3/5 3 (30 sec. each)2pm 6cm Blood stained L Cephalic 156 2 + 3/5 4 (40 sec. each)4pm 6cm Meconium stained L Cephalic 164 3 + 3/5 4 (45 sec. each)History•Labour at home for 6 hours•Membrane ruptured 4 hours before admissionTime 10am 2pm 4pmPulse rate (/Min.) 80 86 92Blood pressure (mmHg) 120/70 130/70 130/70Temperature (oC) 37 37.2 37.2
    • 1. You are called. What would youdo?2. When will you do another vaginalexamination?QuestionsPartograph Case 5Partograph Case 5Maternal and Newborn Health Unit Liverpool School of Tropical MedicineLSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn CareName: Mrs SAHospital No.: 462432 XYAge (Years): 24Parity: Para 3+1Gestational age (Weeks): 39Time Cervix(cm)Membranes/LiquorLie Presentation FHR (/Min.) Moulding Descent Contractions(/10 Min.)10am 4cm Spontaneousrupture 2 hoursago, clearLCephalic140 0 3/5 3 (30 seconds)2pm 8cm Clear L Cephalic 156 1+ 3/5 3 (40 seconds)4pm 9cm Clear L Cephalic 120 2+ 1/5 4 (45 seconds)History•Lower abdominal pains 3 hours•Drainage of liquor 2 hoursTime 10am 2pm 4pmPulse rate (/Min.) 86 90 92Blood pressure (mmHg) 130/70 130/70 130/70Temperature (oC)37o37o 37
    • 1. Comment on the partograph.2. What action would you take?QuestionsPartograph Case 5Partograph Case 5Maternal and Newborn Health Unit Liverpool School of Tropical MedicineLSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn CareName: Mrs SAHospital No.: 462432 XYAge (Years): 24Parity: Para 3+1Gestational age (Weeks): 39Time Cervix(cm)Membranes/LiquorLie Presentation FHR (/Min.) Moulding Descent Contractions(/10 Min.)10am 4cm Spontaneousrupture 2 hoursago, clearLCephalic140 0 3/5 3 (30 seconds)2pm 8cm Clear L Cephalic 156 1+ 3/5 3 (40 seconds)4pm 9cm Clear L Cephalic 120 2+ 1/5 4 (45 seconds)History•Lower abdominal pains 3 hours•Drainage of liquor 2 hoursTime 10am 2pm 4pmPulse rate (/Min.) 86 90 92Blood pressure (mmHg) 130/70 130/70 130/70Temperature (oC)37o37o 37
    • 1. Comment on the partograph?2. What action will you take?3. What are the options for delivery?QuestionsPartograph Case 5Partograph Case 5Maternal and Newborn Health Unit Liverpool School of Tropical MedicineLSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn CareName: Mrs SAHospital No.: 462432 XYAge (Years): 24Parity: Para 3+1Gestational age (Weeks): 39Time Cervix(cm)Membranes/LiquorLie Presentation FHR (/Min.) Moulding Descent Contractions(/10 Min.)10am 4cm Spontaneousrupture 2 hoursago, clearLCephalic140 0 3/5 3 (30 seconds)2pm 8cm Clear L Cephalic 156 1+ 3/5 3 (40 seconds)4pm 9cm Clear L Cephalic 120 2+ 1/5 4 (45 seconds)History•Lower abdominal pains 3 hours•Drainage of liquor 2 hoursTime 10am 2pm 4pmPulse rate (/Min.) 86 90 92Blood pressure (mmHg) 130/70 130/70 130/70Temperature (oC)37o37o 37