Partograph
Presented by : Sw r j
(Roll no: 144)
Moder tor: Dr Sheet l M m
a
a
a
a
a
De nition
• 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.
fi
Advantages of using Partograph
• A single sheet of paper can provide details of necessary information at a glance.
• No need to record labour events repeatedly
• Gives clear picture of normality and abnormality in labour.
• It can predict deviation from duration of labour. So appropriate steps could be
taken in time.
Advantages of using Partograph
• It facilitates handover procedure of sta s.
• Save working time of sta against writing labour notes in long hand.
• Educational value for all
ff
ff
Principles of plotting partograph
• The active phase of labour commence at 4 cm cervical dilatation.
• The latent phase of labour should not last longer than 8 hours.
• During active labour, the rate of cervical dilatation should not be slower than 1cm/
hours.
• A lag time at 4 hours between a slowing of labour and the need for intervention is
unlikely compromises the fetus or the woman and avoid unnecessary intervention
Method of recording partograph
Patient information: Fill out name, gravida, para, hospital number, date and time of
admission and time of ruptured membranes
Method of recording partograph
• Fetal heart rate: The rate of the fetal heart rate indicates the state of the fetus
inside the uterus.
Record every half hour.
Method of recording partograph
• Amniotic uid: Record the colour of amniotic uid at every vaginal examination:
• I: membranes intact;
• C: membranes ruptured, clear uid;
• M: meconium-stained uid;
• B: blood-stained uid.
fl
fl
fl
fl
fl
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, ten square vertically, each square
indicate one centimeter of cervical dilatation.
Cervical dilatation
Cervical dilatation
• The cross (X) in the graph are joined by a continuous line begin plotting on the
partograph at 4 cm.
• The climbing tendency of this line normally lies on the left of the middle of the
graph.
• Alert line: A line starts at 4 cm of cervical dilatation to the point of expected full
dilatation at the rate of 1 cm per hour.
• Action line: Parallel and 4 hours to the right of the alert line
Descent of the head
• This is assessed by abdominal examination before doing vaginal examination.
• Refers to the part of the head (divided into 5 parts) palpable above the symphysis
pubis.
• Recorded as a circle (O) at every vaginal examination.
Uterine contractions
• Uterine contractions 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 number of contractions in 10 minutes and their duration in seconds
Uterine contraction
• Less than 20 seconds:
• Between 20 and 40 seconds:
• More than 40 seconds:
Uterine contraction
Oxytocin drip
• This consists of two lines, one for the record of unit of oxytocin per liter of
intravenous uid and other one is for drop of uid per minute.
• The recording can be made at the interval of 30minutes as the uterine contraction
fl
fl
Drugs and other intravenous uids
• Record any additional drug given and are recorded at the particular point of time.
• This includes sedatives, antibiotics, IV uids etc. The name of the drugs and doses
given should be written clearly in the long box.
fl
fl
Maternal condition
• Pulse: Record every 30 minutes and mark with a dot (.).
• Blood pressure: Record every 4 hours and mark with arrows.
• Temperature: Record every 2 hours.
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.
Thank you
