2. DEFINITION
ā¢It is a composite graphical recording
of cervical dilatation and descent of
head against duration of labour in
hours.
ā¢It also gives information about fetal
and maternal condition that are all
recorded on single sheet of paper.
3. PRINCIPLES OF
PARTOGRAPH
ā¢The active phase of labour commence at 4
cm cervical dilatation.
ā¢The latent phase of labour should not last
longer than 8 hrs.
ā¢During active labour, the rate of cervical
dilatation should not be slower then 1cm/
hr.
ā¢Every 4 hrs. vagial examination is
recommended.
7. USE OF PARTOGRAPH
ā¢Patients information :
ļ¼Fill out name
ļ¼Gravida
ļ¼Para
ļ¼Hospital no.
ļ¼Date and time of admission
ļ¼Time of ruptured membrane
ļ¼hours
8. CONTD.
ā¢Fetal heart rate :
ā¢ The rate of the fetal heart rate indicates the state of
the fetus inside the uterus .
ā¢ Record every half hrs.
ā¢ 180bpm = tachycardia
ā¢ 160bpm = bradycardia
ā¢ 100bpm = severe bradycardia
9. CONTD.
ā¢ Amniotic fluid : record the colour of amniotic fluid at
every vaginal examination ā
ļ¼I = membranes intact
ļ¼R = membranes ruptured, clear fluid
ļ¼M = meconium-stained fluid
ļ¼B = blood-stained fluid
ļ¼A = absent amniotic fluid
10. CONTD.
ā¢ moulding : is a state of reduction or loss of space
between skull bones.
ā¢ Recording of degree of moulding =
ļ¼Separated bones, sutures felt easily ā 0
ļ¼Bones just touching each other ā +1
ļ¼Overlapping bones ā +2
ļ¼Severely overlapping bones ā +3
11. CONTD.
ā¢(A)Cervical dilatation :
ļ¼Assessed at every vaginal
examination and marked with
a cross (x).
ļ¼Begin plotting on the
partograph at 4 cm.
ļ¼This graph consists of
homogenous squares, 10
square vertically , each
square indicate 1 cm of
cervical dilatation.
12. CONTD.
(B) Decent of the head :
ļ¼this is assessed by abdominal examination before
doing vaginal examination.
ļ¼Refers to the part of the head palpable above the
symphysis pubis.
ļ¼Recorded as circle (o) at every vaginal examination.
13. CONTD.
ā¢Uterine contractions :
ļ¼Uterine contraction are recorded
graphically on the partograph
according to their strength and
frequency.
ļ¼Observation of contraction is made
half hourly in the active phase.
ļ¼Palpate the no. of contractions in 10
mins and their duration in sec.
14. CONTD.
ā¢Oxytocin drip :
ļ¼This consists of two line, one for the record of unit of
oxytocin per litter of iv fluid and other one is for drop
of fluid per min.
ļ¼The recording can be made at the interval of 30 mins.
As the uterine contraction.
15. CONTD.
ā¢Drugs and iv fluids :
ļ¼Record any additional drug given and are recorded at
the particular point of time.
ļ¼This includes sedatives, antibiotics , iv fluids etc. The
name of the drugs does given should be written in the
long box.
16. CONTD.
ā¢Maternal condition :
ļ¼Pulse ā record every 30 mins and mark with a dot (.)
ļ¼B.P. ā record every 4 hrs and mark with arrows.
ļ¼Temperature ā record every 2 hrs.
17. CONTD.
ā¢Urine analysis :
ļ¼During the course of labour, the examination
of urine is important.
ļ¼In case of maternal distress the volume of
urine may decrease and it may contain ketone
bodies.