Partograph during 1 stage of labour

1. PARTOGRAPH
PRESENTED BY –
PREETI KULSHRESTHA
M.SC. NURSING PREVIOUS YEAR

2. DEFINITION
•It is a composite graphical recording
of cervical dilatation and descent of
head against duration of labour in
hours.
•It also gives information about fetal
and maternal condition that are all
recorded on single sheet of paper.

3. PRINCIPLES OF
PARTOGRAPH
•The active phase of labour commence at 4
cm cervical dilatation.
•The latent phase of labour should not last
longer than 8 hrs.
•During active labour, the rate of cervical
dilatation should not be slower then 1cm/
hr.
•Every 4 hrs. vagial examination is
recommended.

5. ALERT LINE AND ACTION LINE

6. PARTOGRAPH
OLD PARTOGRAPH NEW PARTOGRAPH

7. USE OF PARTOGRAPH
•Patients information :
Fill out name
Gravida
Para
Hospital no.
Date and time of admission
Time of ruptured membrane
hours

8. CONTD.
•Fetal heart rate :
• The rate of the fetal heart rate indicates the state of
the fetus inside the uterus .
• Record every half hrs.
• 180bpm = tachycardia
• 160bpm = bradycardia
• 100bpm = severe bradycardia

9. CONTD.
• Amniotic fluid : record the colour of amniotic fluid at
every vaginal examination –
I = membranes intact
R = membranes ruptured, clear fluid
M = meconium-stained fluid
B = blood-stained fluid
A = absent amniotic fluid

10. CONTD.
• moulding : is a state of reduction or loss of space
between skull bones.
• Recording of degree of moulding =
Separated bones, sutures felt easily – 0
Bones just touching each other – +1
Overlapping bones – +2
Severely overlapping bones – +3

11. CONTD.
•(A)Cervical dilatation :
Assessed at every vaginal
examination and marked with
a cross (x).
Begin plotting on the
partograph at 4 cm.
This graph consists of
homogenous squares, 10
square vertically , each
square indicate 1 cm of
cervical dilatation.

12. CONTD.
(B) Decent of the head :
this is assessed by abdominal examination before
doing vaginal examination.
Refers to the part of the head palpable above the
symphysis pubis.
Recorded as circle (o) at every vaginal examination.

13. CONTD.
•Uterine contractions :
Uterine contraction are recorded
graphically on the partograph
according to their strength and
frequency.
Observation of contraction is made
half hourly in the active phase.
Palpate the no. of contractions in 10
mins and their duration in sec.

14. CONTD.
•Oxytocin drip :
This 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.
The recording can be made at the interval of 30 mins.
As the uterine contraction.

15. CONTD.
•Drugs and iv fluids :
Record any additional drug given and are recorded at
the particular point of time.
This includes sedatives, antibiotics , iv fluids etc. The
name of the drugs does given should be written in the
long box.

16. CONTD.
•Maternal condition :
Pulse – record every 30 mins and mark with a dot (.)
B.P. – record every 4 hrs and mark with arrows.
Temperature – record every 2 hrs.

17. CONTD.
•Urine analysis :
During the course of labour, the examination
of urine is important.
In case of maternal distress the volume of
urine may decrease and it may contain ketone
bodies.

18. Thank you