The document describes how to use a partograph to monitor labor progress. A partograph should be used for all women admitted to the labor ward. It monitors cervical dilation, fetal heart rate, contractions, amniotic fluid, and any oxytocin administered. Lines on the partograph indicate when action should be taken if progress is too slow, such as artificial rupture of membranes, oxytocin augmentation, correcting malposition, or cesarean section. The partograph is an important tool for safely monitoring labor.

1. The Partograph

3. Partograph
• Use partograph to monitor progress of
labour at all women admitted to labour
ward
• Women should not be admitted for labour
ward until in active labour
• Active labour is when women have regular
contractions (3-5 in ten minutes) and
cervix is 4 cm. dilated

4. Fetal Heart Rate:
• Assess after contraction for 60 seconds:
• Each 30 minutes in first stage (each 15
minutes if risk factors are identified
• Each 5 minutes when pushing

5. Cervical Dilatation
• Assessed each 4 hours (or before if a crossed
action line is anticipated)
Alert Line:
• Start recording cervical dilatation in the alert line.
• As long as dilatation is 1 cm or more/hr the alert
line is not crossed.
• If cervical dilatation is < 1 cm/hr the alert is
crossed and causes of prolonged labour should
be considered: always consider: artificial rupture
of membranes and augmentation with oxytocin.

6. Cervical dilatation
Action Line:
• If the action line is crossed the actions
should be as follows in mentioned order (if
not already performed)
• ARM and oxytocin augmentation
• Correction of malposition
• Cesarean Section or Vacuum (if in second
stage and descend is 1/5 or below)

7. Amniotic fluid:
I= Intact Membranes
C= Clear
M= Meconium stained
B= Blood stained
Remember: the diagnosis
“cephalopelvic disproportion” cannot
be made with intact membranes!

8. Contractions:
Chart every 30 minutes
Number/10 minutes and Duration
• Weak: Lasting <20 seconds Medium:
Lasting 20-40 seconds Strong: Lasting
>40 seconds
Oxytocin:
• Record oxytocin (amount/volume) and
drops / minute