Partograph

When Partograph should be initiated

When Cervical Dilatation is 4 cm
Uterine contractions two or more in 10min.
and last for at least 20 seconds.

Points to remember while using

Partograph

It is only a tool for managing labour progress

Only start partograph who dont have complications and doesn't require
Referral.
Progress of labour is satisfactory, if the plotting of cervical dilation remain
on/to the left of the Alert line
Cervical dilation plotted as X
Assessing descent of the head helps in detecting progress of labour
Infrequent vaginal examination (once in every 4hrs)
When the woman arrives to the hospital the time of admission is O time
A woman whose cervical dilation moves to the right of the Alert line must
be transferred for obstetric interventions

Case A
Glenda was admitted at 12:00pm, G2 P1, BP=110mmHg,, PR = 90bpm,
FHR,=130bpm, T=36.8CIE showed 5cm dilated cervix
Still with (+) BOW

At 4pm, FHR=140bpm, cervix dilatation is 7cm,

BP=120/90mmHg, (+)BOW
At 5:00pm, cervix was 9cm (-) BOW clear, she delivered spontaneously at
5:30pm. 10U oxytocin given IM. Placenta was delivered at 5:30pm.

Quick action warranted in labour

during following conditions
Delay in cervical dilatation is 1cm/hr
Delay in descent of the head
FHR < 120 or > 160/min. on 3 observation
ROM and Meconium stained
ROM and Absence of liquor and fetal skull Moulding with bones
touching each other / overlapping / severe overlapping

CONCLUSION
The partograph gives healthcare providers objective data on which
to base their clinical decisions and enhances communication
among members of the team of providers who are
caring for the mother, so that decisions can be made in a
timely manner.