Partograph exercises

10,326 views

Published on

Published in: Health & Medicine, Business
1 Comment
21 Likes
Statistics
Notes
No Downloads
Views
Total views
10,326
On SlideShare
0
From Embeds
0
Number of Embeds
46
Actions
Shares
0
Downloads
4,575
Comments
1
Likes
21
Embeds 0
No embeds

No notes for slide

Partograph exercises

  1. 1. 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
  2. 2. 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
  3. 3. 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
  4. 4. 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
  5. 5. 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
  6. 6. 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
  7. 7. 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
  8. 8. 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
  9. 9. 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
  10. 10. 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
  11. 11. 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
  12. 12. 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
  13. 13. 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
  14. 14. 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

×