Partogram

This chapter reviews and compiles the most recent published evidence assessing the overall labour duration and patterns of progression for both nulliparous and parous women, as well as the accuracy of the alert and action lines in the World Health Organization (WHO) partograph for the identification of women at risk of birth complications. Systematic reviews of observational studies reporting on the duration of the first and the second stages of labour, and on cervical dilatation patterns for women with low risk of complications with 'normal' perinatal outcomes were identified and updated...

OBJECTIVE:  This study was aimed to describe continuous labor curves, including second stage, based on fetal head station. STUDY DESIGN:  We performed a prospective multicenter cohort study. The inclusion criteria were women with singleton uncomplicated cephalic term pregnancies in labor, who delivered vaginally. We used a device that combines ultrasound imaging with position-tracking technology to monitor the head station noninvasively throughout labor. We collected data on demographics, labor parameters, and delivery and neonatal outcomes...

BACKGROUND: Timely identification and management of intrapartum complications could significantly reduce maternal deaths, intrapartum stillbirths, and newborn deaths due to hypoxia. The World Health Organization (WHO) identifies monitoring of labor using the paper partograph as a high-priority intervention for identifying abnormities in labor and fetal well-being. This article describes a mixed-method, quasi-experimental study to assess the effectiveness of an Android tablet-based electronic, labor clinical decision-support application (ePartogram) in limited-resource settings...

BACKGROUND: Controversy surrounds the definition of "normal" and "abnormal" labor. OBJECTIVE: In this study, we used contemporary labor charts to explore labor patterns in large obstetric population (2011-2016). STUDY DESIGN: Detailed information from electronic medical records of live singleton deliveries at term (≥37 weeks of gestation) was extracted. Cases of elective cesarean deliveries, nonvertex presentation, and cesarean deliveries during the first stage of labor were excluded...

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OBJECTIVE: This study sought to determine whether obese pregnant women undergo cesarean sections without an adequate trial of labour. This may affect future birth and pregnancy outcomes. METHODS: A retrospective analysis was done on 526 parturients at Victoria Hospital in London, Ontario. Women were categorized according to parity and pre-pregnancy body mass index (BMI; normal weight, BMI 18.5-24.9 kg/m2 ; obese class II, BMI 35.0-39.9 kg/m2 ; obese class III, BMI ≥40 kg/m2 )...

BACKGROUND: Per-partum stillbirth continues to represent a public health burden despite the efforts of countries around the world. Prevention of this mortality can only be effective with a better knowledge of factors that are life-threatening to the fetus or newborn. This work aims to determine associated factors with intrapartum and very early neonatal mortality. METHODS: A case-control study was carried out at the maternity of the university hospital in Marrakech, where 290 subjects were selected: 145 cases of intrapartum fetal death or a very early neonatal death, and 145 controls of surviving newborn weighing 2500g or more at birth...

Objective: To analyze labor progression characteristics among nulliparas and provide reference to labor progress management. Methods: A retrospective study was conducted on 1 089 women who went for vaginal delivery at the First Affiliated Hospital, Sun Yet-San University from January 1st, 2015 to May 31th, 2016. The duration of cervical dilation from 1.0 cm to the next and the process of initial cervical dilation (2.0 cm or 3.0 cm) to full cervical dilation of nulliparas were analyzed. Results: The cervical dilation speed was accelerating with the progress of labor...

OBJECTIVE: to explore and describe the use of the partogram in private hospitals in South Africa. DESIGN: an explanatory mixed method design. In-depth interviews were conducted with the midwives and midwife specialists to explicate the significance of the initial quantitative questionnaires. SETTING: a private maternity hospital in Gauteng Province, South Africa. PARTICIPANTS: 11 midwives and 3 advanced midwives working in the labour unit of the private maternity hospital...

BACKGROUND: The partograph (sometimes known as partogram) is usually a pre-printed paper form on which labour observations are recorded. The aim of the partograph is to provide a pictorial overview of labour, and to alert midwives and obstetricians to deviations in maternal or fetal well-being and labour progress. Charts have traditionally contained pre-printed alert and action lines. An alert line, which is based on the slowest 10% of primigravid women's labours, signifies slow progress...

We have examined the nurses' thinking process in their professional judgment and action in the Partogram of 170 labors by 17 Midwifery students in 2 years.

OBJECTIVE: To identify the factors associated with quality decision-making of healthcare professionals in managing complicated labour and delivery in referral hospitals of Burkina Faso. METHODS: We carried out a six-month observational cross-sectional study among 123 healthcare professionals performing caesareans in 22 hospitals. Clinical decision-making was evaluated using hypothetical patient vignettes framed around four main complications during labour and delivery and developed using guidelines validated by an expert committee...

OBJECTIVE: (1) to assess variations in oxytocin use by midwives during spontaneous labour (indication, dose, moment), and (2) to identify factors potentially associated with oxytocin administration. DESIGN: descriptive cross-sectional study using a case-vignette and questionnaire among French midwives from November 2015 to May 2016. METHODS: Midwives were asked to complete an online survey including a case-vignette with hourly partograms of a slowly progressing labour, and a short self-administered questionnaire...

OBJECTIVE: To describe practices and interventions used during labor and childbirth and factors associated with such practices in puerperae in the state of Sergipe. METHOD: A cross-sectional study with 768 postpartum women from 11 maternity hospitals interviewed 6 hours after delivery, and hospital records review. The associations between best practices and interventions used during labor and delivery with exposure variables were described using simple frequencies, percentages, crude and adjusted odds ratio (ORa) with the confidence interval...

BACKGROUND: In Brazil, 88% of births among women with private insurance are caesarean sections, even though a caesarean rate above 15% is associated with greater maternal and child morbidity and mortality. Aiming to reduce unnecessary caesarean sections in the private sector, in July 2015 the Brazilian government enacted Resolução Normativa 368, a regulation requiring the use of partograms, pre-natal cards to document pregnancies, and consent forms for elective caesareans, and recommending that obstetricians provide women with an informational letter about birth...

AIM: This study was conducted to evaluate the ability of the effacement curve to predict fetal descent by comparing it to dilatation in order to improve the accuracy of the current partogram. METHOD: We conducted an observational study of women who were admitted for vaginal delivery at Mobini Hospital, Sabzevar, Iran in 2015. During labor, dilatation and effacement were plotted in different graphs and then their association with fetal descent was separately evaluated and compared...

OBJECTIVE: The purpose of the research was to assess the content and quality of the intrapartum care offered in vaginal births in Turkey, based on the example of a state hospital. MATERIALS AND METHODS: This cross-sectional study was conducted between January 1st , 2013 and December 31st , 2014 at Aydın Maternity and Children's Hospital. The study sample consisted of 303 women giving vaginal birth, who were recruited into the study using the method of convenience sampling...

BACKGROUND: Audit and feedback is regarded as the cornerstone of clinical teaching to guarantee good practice and to correct poor performance. Feedback given to health professionals assists in narrowing the gap between the actual and the desired information. The findings of the research study on perceptions of midwives on audit and feedback highlighted aspects that needed improvement to address challenges on the use and documentation of the partogram. OBJECTIVES: The objectives of this article were to explore and describe the perceptions of midwives on auditing of the partogram by health professionals and to explore and describe the perceptions of midwives on the feedback that was given after audit was done...

Maternal and neonatal mortality and morbidity associated with childbirth is a problem of the highest priority. This research has been aimed at testing a modified version of the WHO Safe Childbirth Checklist in one Italian hospital and to evaluate the tool in terms of its impact on clinical practice and safety. Results show that the presence of correctly compiled partogram tool is strongly and significantly associated with the checklist implementation (OR = 14.9, 95% confidence interval [CI] = 3.5, 63.9). Compliance to the checklist was high for mid-wives (96%) and very low for obstetricians (3%)...

BACKGROUND: Maternal mortality continues to be a global burden, with more than 200 million women becoming pregnant each year and a large number dying as a result of complications of pregnancy or childbirth. The World Health Organisation has recommended use of the partogram to monitor labour and delivery in order to improve healthcare and reduce maternal and foetal mortality rates. OBJECTIVE: This study described factors affecting utilisation of the partogram among nurses and midwives in selected health facilities of Rwanda...