partograph , cervicograph , components of partograph , advantages of a partograph

1. - DR. SUPRIYA MAHIND

2.  Partograph is a composite graphical record of key data
(maternal and fetal) during labor, entered against
time on a single sheet of paper.
 In cervicograph , the alert line starts at 4 cm (WHO) of
cervical dilatation and ends at 10 cm dilatation (at the
rate of 1 cm/hr)
 The action line is drawn 4 hours to the right and
parallel to the alert line. In a normal labor, the
cervicograph (cervical dilatation) should be either
on the alert line or to the left of it.

3. Partographic analysis of labor to detect types of
prolonged labor—protracted latent phase, protracted active phase
and secondary arrest

4. Cervicograph showing slow (protracted) cervical dilatation and descent of
the presenting part. Oxytocin infusion was started following amniotomy.
Partograph showed arrest in the progress in spite of adequate
contractions. Labor was terminated by cesarean section

5.  When it falls on Zone 2 it is abnormal and need to be
critically assessed.
 When it falls in Zone 3 case should be reassessed by a
senior person.
 Decision is to be made either for termination of
labor (cesarean section) or for augmentation of labor
(amniotomy and or oxytocin).

7. (a) Patient identification
(b) Time — recorded at hourly interval. Zero time for
spontaneous labor is the time of admission in the labor
ward and for induced labor is the time of induction
(c) Fetal heart rate — recorded at every 30 minutes
(d) State of membranes and color of liquor : to mark ‘I’ for
intact membranes, ‘C’ for clear and ‘M’ for meconium
stained liquor
(e) Cervical dilatation and descent of the head .

8. f) Uterine contractions — the squares in the vertical
columns are shaded according to duration and
intensity .
(g) Drugs and fluids
(h) Blood pressure (recorded in vertical line) at
every 2 hours and pulse at every 30 minutes
(i)Oxytocin — concentration in the upper box and
dose (m IU/min) in the lower box

9. (j) Urine analysis
(k) Temperature record

10. Advantages of a partograph:
(i) A single sheet of paper can provide details of necessary
information at a glance;
(ii) No need to record labor events repeatedly;
(iii) It can predict deviation from normal progress
of labor early. So, appropriate steps could be taken in time
(iv) It facilitates handover procedure;
(v) Introduction of partograph in the management of labor
(WHO 1994) has reduced the incidence of prolonged labor and
cesarean section rate.
There is improvement in maternal morbidity,
perinatal morbidity and mortality.

11. THANK YOU