Partogram

As in other areas of international development, we are witnessing the proliferation of 'traveling models' developed by international experts and introduced in an almost identical format across numerous countries to improve some aspect of maternal health systems in low- and middle-income countries. These policies and protocols are based on 'miracle mechanisms' that have been taken out of their original context but are believed to be intrinsically effective in light of their operational devices.In reality, standardised interventions are, in Africa and elsewhere, confronted with pragmatic implementation contexts that are always varied and specific, and which lead to drifts, distortions, dismemberments and bypasses...

BACKGROUND: Labor that progresses faster than anticipated may lead to unplanned out-of-hospital births. With the aim to improve planning of transportation to birthing institutions, this study investigated predictors of time to completion for the first stage of labor conditional on cervical opening (conditional time) in multiparous women at term. METHODS: We performed a retrospective analysis of partograms for women in Robson's group 3 who delivered at one hospital from 2003 to 2013...

BACKGROUND: The partograph (or partogram) is recommended by the World Health Organisation (WHO), for monitoring labour wellbeing and progress. Concerns about limitations in the way the partograph is used in the clinical context and the potential impact on its effectiveness have led to this realist systematic review of partograph use. METHODS: This review aimed to answer two key questions, 1) What is it about the partograph that works (or does not work); for whom does it work; and in what circumstances? 2) What are the essential inputs required for the partograph to work? A comprehensive search strategy encompassed key databases; including papers of varying methodologies...

OBJECTIVE: Describing the obstetric care provided in public maternity hospitals during normal labour using the Bologna Score in the city of Natal, Northeastern Brazil. METHOD: A quantitative cross-sectional study conducted with 314 puerperal women. Data collection was carried out consecutively during the months of March to July 2014. RESULTS: Prenatal care was provided to 95.9% of the mothers, beginning around the 1st trimester of pregnancy (72...

OBJECTIVE: To determine the prevalence of cesarean deliveries in Burkina Faso, analyze the indications for them and the outcomes, and identify factors associated with non-absolute maternal indications for the procedure, as opposed to major obstetric interventions performed to save a woman's life. METHODS: In a cross-sectional study, we selected and analyzed cesarean deliveries among those most recently performed between May 2009 and April 2010 in all facilities in Burkina Faso...

INTRODUCTION: Anti-fibrinolytic agents are used to reduce obstetric blood loss as the fibrinolytic system is known to get activated after placental delivery. OBJECTIVES: To evaluate the efficacy of parenteral tranexamic acid in reducing blood loss during normal labour and to compare it with the amount of blood loss in patients who received placebo in the third stage of labour. METHODOLOGY: Patients with spontaneous labour or planned for induction of labour and fulfilling the inclusion criteria were recruited for the study...

BACKGROUND: Each year, 1.2 million intrapartum stillbirths occur globally. In Nepal, about 50 % of the total number of stillbirths occur during the intrapartum period. An understanding of the risk factors associated with intrapartum stillbirth will facilitate the development of preventative strategies to reduce the associated burden of death. This study was conducted in a tertiary-care setting with the aim to identify risk factors associated with intrapartum stillbirth. METHODS: A case-control study was completed from July 2012 to September 2013...

BACKGROUND: Newborns are at the greatest risk for dying during the intrapartum period, including labor and delivery, and the first day of life. Fetal heart rate monitoring (FHRM) and partogram use to track labor progress are evidence-based techniques that can help to identify maternal and fetal risk factors so that these can be addressed early. The objective of this study was to assess health worker adherence to protocols for FHRM and partogram use during the intrapartum period, and to assess the association between adherence and intrapartum stillbirth in a tertiary hospital of Nepal...

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OBJECTIVE: To study the changes of intrapartum cesarean rate, cesarean indications and pregnancy outcomes after the new partogram applied. METHODS: Totally 3 290 pregnant women trying to vaginal delivery which were managed according to the new partogram in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from August to October in 2014(new partogram group)were involved; 2 987 pregnancy women trying to vaginal delivery from May to July in 2014 which were managed according to the old partogram(old partogram group)were involved as control...

BACKGROUND: The partogram is the most effective tool to use to monitor the progress of labour and complications associated with labour. The main objective of this study was to assess the knowledge level of midwives on the effective use of the partogram in monitoring the progress of labour in the Tamale Metropolis of Ghana. METHODS: This study was a cross-sectional descriptive study conducted on 140 midwives selected using random sampling technique from March to July, 2011...

BACKGROUND: A major problem of the first moments of childbirth, especially in "prolonged labor," is perinatal asphyxia which necessitates neonatal resuscitation. This study aimed at evaluating the alert line of the partogram in recognizing the need for neonatal resuscitation 20-30 s after delivery. MATERIALS AND METHODS: 140 full-term pregnant women were kept under surveillance through using a partogram. In order to decide on the onset of resuscitation, the three indicators of fetal respiration, heart rate, and skin color were used 20-30 s after delivery...

OBJECTIVE: To assess the contribution of a new type of partogram, used in labor monitoring, in caesarean section rates. MATERIAL AND METHODS: The study included term singleton uncomplicated pregnancies divided into two groups. Two types of partogram were used in labor monitoring. In the first group, the classical WHO partogram (A) was used. In the second group, a new type of partogram, in which cervical dilatation and the position of descending head (B) (one line) were estimated and reported, was used...

OBJECTIVE: The objective of the study was to evaluate the intra- and interobserver agreement among obstetric experts in court regarding the retrospective review of abnormal fetal heart rate tracings and obstetrical management of patients with abnormal fetal heart rate during labor. STUDY DESIGN: A total of 22 French obstetric experts in court reviewed 30 cases of term deliveries of singleton pregnancies diagnosed with at least 1 hour of abnormal fetal heart rate, including 10 cases with adverse neonatal outcome...

PROBLEM: Suboptimal care contributes to perinatal mortality rates. Quality-of-care audits can be used to identify and change suboptimal care, but it is not known if such audits have reduced perinatal mortality in South Africa. APPROACH: We investigated perinatal mortality trends in health facilities that had completed at least five years of quality-of-care audits. In a subset of facilities that began audits from 2006, we analysed modifiable factors that may have contributed to perinatal deaths...

OBJECTIVE: The objective of this study was to assess the association between the quality of basic note keeping and partogram documentation with progression of shift and workload on labour ward. DESIGN: This was a prospective observational study. SETTING: The setting of this study was a labour ward of a teaching district hospital in an inner city London hospital. METHODS: Intrapartum notes and partograms of 61 consecutive labouring women were assessed for quality of midwifery documentation at the beginning, middle and end of a 12-h shift...

In a recent review by Cohen and Friedman, several statistical questions on modeling labor curves were raised. This article illustrates that asking data to fit a preconceived model or letting a sufficiently flexible model fit observed data is the main difference in principles of statistical modeling between the original Friedman curve and our average labor curve. An evidence-based approach to construct a labor curve and establish normal values should allow the statistical model to fit observed data. In addition, the presence of the deceleration phase in the active phase of an average labor curve was questioned...

BACKGROUND: Increasing the number of women birthing with skilled birth attendants (SBAs) as one of the strategies to reduce maternal mortality and morbidity must be partnered with a minimum standard of care. This manuscript describes the quality of intrapartum care provided by SBAs in Mae La camp, a low resource, protracted refugee context on the Thai-Myanmar border. METHODS: In the obstetric department of Shoklo Malaria Research Unit (SMRU) the standardized WHO Safe Motherhood Needs Assessment tool was adapted to the setting and used: to assess the facility; interview SBAs; collect data from maternal records during a one year period (August 2007 - 2008); and observe practice during labour and childbirth...

OBJECTIVES: The aim of this study was to investigate if there are clinical signs which allow detection of malposition of the vertex on admission to the delivery unit, or when crossing the action line on the partogram. STUDY DESIGN: Case-control study from 2007 to 2010 conducted on the delivery unit of Nordland Hospital, Bodø. Labours with malposition of the vertex (n = 171) were compared with a group with normal vertex presentation (n = 165). The positive predictive value was estimated for each sign using Bayes' rule...