Partogram
A partogram or partograph is a composite graphical record of key data (maternal and fetal) during labour entered against time on a single sheet of paper. Relevant measurements might include statistics such as cervical dilation, fetal heart rate, duration of labour and vital signs.[1]
It is intended to provide an accurate record of the progress in labour, so that any delay or deviation from normal may be detected quickly and treated accordingly. However, a Cochrane review came to the conclusion that there is insufficient evidence to recommend partograms in standard labour management and care.[2]
Components
- Patient identification
- Time: It is recorded at an interval of one hour. Zero time for spontaneous labour is time of admission in the labour ward and for induced labour is time of induction.
- 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.
- Cervical dilatation and descent of head
- Uterine contractions: Squares in vertical columns are shaded according to duration and intensity.
- 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.
- Oxytocin: Concentration is noted down in upper box; while dose is noted in lower box.
- Urine analysis
- Temperature record
Advantages
- Provides information on single sheet of paper at a glance
- No need to record labour events repeatedly
- Prediction of deviation from normal progress of labour
- Improvement in maternal morbidity, perinatal morbidity and mortality
Usage
A partogram is contained in the Perinatal Institute's "Birth notes".[3]
Use of a partogram in established labour is recommended by the National Institute for Clinical Excellence (NICE) http://www.nice.org.uk/ in the "Intrapartum Care" guideline.[4]
References
- ^ "Archived copy" (PDF). Archived from the original (PDF) on 2011-09-27. Retrieved 2011-06-29.
{{cite web}}: Unknown parameter|deadurl=ignored (|url-status=suggested) (help)CS1 maint: archived copy as title (link) - ^ Lavender, T.; Hart, A.; Smyth, R. M. (2008). "Effect of partogram use on outcomes for women in spontaneous labour at term". The Cochrane Library. doi:10.1002/14651858.CD005461.pub2. PMC 4161496.
- ^ "Perinatal Institute". www.perinatal.org.uk.
- ^ "Intrapartum care: care of healthy women and their babies during childbirth". NICE guidelines [CG190]. December 2014. Retrieved 6 December 2014.