Partograph

Subject: Midwifery II (Theory)

Overview

A partograph is a combined picture record of significant fetal and mother data that was entered against time on a single piece of paper during childbirth. Relevant data may include measurements of cervical dilation, fetal heart rate, labor duration, and vital signs. The alert line is 4 hours to the right of an action line that runs parallel to it. The latent phase of labor should not last longer than 8 hours, the Pv examination should be performed as infrequently as is consistent with safe practice, and the rate of cervical dilation during active labor should not be slower than 1cm/hour. All of these factors should be taken into consideration when plotting the partograph.

A partograph is a combined picture record of significant fetal and mother data that was entered against time on a single piece of paper during childbirth. Relevant data may include measurements of cervical dilation, fetal heart rate, labor duration, and vital signs.

Several partograms that show cervical dilation versus time have an alert line. When the cervical dilation reaches 3 or 4 cm, it starts. After that, the process is repeated diagonally at a rate of 1.5 cm for multigravidae and 1 cm for primigravidae. The alert line is 4 hours to the right of an action line that runs parallel to it.

Advantages

  • On a single piece of paper, information is presented briefly.
  • It is not necessary to continuously record labor activity.
  • Forecast of deviation from normal labor progress Death, perinatal morbidity, and maternal morbidity have all improved.
  • It illustrates both normal and unusual features of work.
  • By eliminating the need to manually create labor notes, staff time is saved.
  • Value of each employee's evaluation.

Components

  • The patient's identification.
  • Every thirty minutes, the fetal heart rate is measured.
  • Membrane condition and liquid hue: "I" stands for intact membranes, "C" for clear liquid, and "M" for meconium-stained liquid.
  • Descent of the fetal head
  • Cervical dilatation
  • Squares in vertical columns are colored according to the duration and severity of the contraction of the uterus.
  • Oxytocin: The upper box lists the concentration, while the lower box lists the dose.
  • Medications and fluids.
  • Every two hours, blood pressure is monitored in vertical lines.
  • Every 30 minutes, the pulse rate is also reported in vertical lines.
  • Urine examination
  • Temperature recorder.

Principles of Plotting Partograph

  • The active stage of labor starts when the cervical cervix is 4 cm dilated. Plotting for partographs should start after the active stage of labor.
  • No more than eight hours should pass during the latent period of labor.
  • During active labor, cervical dilation shouldn't occur more slowly than 1 cm per hour.
  • The frequency of PV testing should be kept as low as feasible while still being safe.
  • Using a pantograph with a pretest line, even if there are too many lines, may lead to further confusion.
Things to remember
  • A partograph is a combined picture record of significant fetal and mother data that was entered against time on a single piece of paper during childbirth.
  • Relevant data may include measurements of cervical dilation, fetal heart rate, labor duration, and vital signs.
  • An alarm line should appear on any partograms that show cervical dilatation as a function of time.
  • When the cervical dilation reaches 3 or 4 cm, it starts.
  • After that, the process is repeated diagonally at a rate of 1.5 cm for multigravidae and 1 cm for primigravidae.
  • The alert line is 4 hours to the right of an action line that runs parallel to it.
  • The latent phase of labor should not last longer than 8 hours, the Pv examination should be performed as infrequently as is consistent with safe practice, and the rate of cervical dilation during active labor should not be slower than 1cm/hour. All of these factors should be taken into consideration when plotting the partograph.
  • Reduced maternal, perinatal, and neonatal morbidity and death are achieved as a result of the use of partograph in the prediction of deviations from normal labor progression.
Questions and Answers

On a single piece of paper, a partograph is a composite pictorial record of important information (maternal and fetal) during labor that was entered against time. Statistics like cervical dilation, fetal heart rate, labor time, and vital signs may be relevant metrics.

An alert line can be seen on a lot of partograms that plot cervical dilation against time. Beginning at the point where the cervical disc has dilated by 3 or 4 cm. The process is then carried out diagonally at a rate of 1.5 cm per hour for multigravidae and 1 cm per hour for primigravidae. Four hours to the right of the alert line, a parallel action line runs along the alert line.

Advantages

  • Gives quick access to information on a single page of paper,
  • There's no need to repeatedly document labor occurrences.
  • Prediction of a divergence from the labor's usual course a reduction in maternal, perinatal, and infant mortality,
  • Depicts the normal and pathological aspects of labor,
  • Prevents employees from having to write labor notes by hand,
  • Value for all employees' evaluations.

Components

  • Patient identification.
  • Fetal heart rate: It is recorded at an interval of thirty minutes.
  • State of membranes and colour of liquor: "I" designates intact membranes, "C" designates clear and "M" designates meconium stained liquor.
  • Descent of fetal head.
  • Cervical dilatation.
  • Uterine contractions: Squares in vertical columns are shaded according to duration and intensity.
  • Oxytocin: Concentration is noted down in upper box; while dose is noted in lower box.
  • Drugs and Fluids.
  • Blood pressure : It is recorded in vertical lines at an interval of 2 hours.
  • Pulse rate: It is also recorded in vertical lines at an interval of 30 minutes.
  • Urine analysis.
  • Temperature record.

Principles of Plotting Partograph

  • The active phase of labour commences at 4 cm cervical dilatation. The plotting of partograph should start after the active phase of labour.
  • The latent phase of labour should be not longer than 8 hours.
  • During active labor, the rate of cervical dilation should not be slower than 1cm/hour.
  • Pv examination should be performed as infrequently as it is compatible with safe practice.
  • Use of pantograph with pretest line, although too many lines say add further confusion.

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