Partograph

By. Ronalyn A. Fabrigas, RN., MN

Credits to:JILLIAN A. BEJOC, MSN, RN ADPCN-EINC TRAINER
General Learning Outcomes

The students will acquire

appropriate knowledge and skills in
using partograph in practice, to
assess and interpret maternal and
fetal conditions and the progress of
labor.
Specific Learning Outcomes
• At the end of the session, the
students will be able to:
➢ Explain the principles of the
partograph as a tool for
prevention of fetal and maternal
complications during labor.
➢ Record clinical observations
accurately on the partograph
Specific Learning Outcomes
➢ Interpret and recognize any
deviations from normal
➢ Describe specific course of action
at the appropriate time
Trivia
➢ “labor curve”
➢ The partograph was originally
designed and used by Prof. R.H.
Philpott of Zimbabwe in 1972.
➢ Later modified and simplified by
WHO
Partograph Definition:
➢ A partograph is a graphic
representation of the progression
of labor and the condition of the
mother and fetus.
➢ A partograph is a tool, not an end
in itself.
➢ It is used to:
-Guide early detection of
prolonged or obstructed labor.
-Inform decision-making in the
management of labor.
REASONS FOR USING THE
PARTOGRAPH
1. Enables nurses to see progress of
labor at a glance on one sheet of
paper.
*replaces lengthy descriptions
REASONS FOR USING THE
PARTOGRAPH
2. Reduction in number of prolonged
labor, labors requiring oxytocin
augmentation and CS.

3. Assists in early decision on transfer,

augmentation or termination of labor.
REASONS FOR USING THE
PARTOGRAPH
4. Increases quality and regularity of
all observations on the fetus and
mother during labor and aids in early
recognition of problems with either of
them.
REASONS FOR USING THE
PARTOGRAPH

5. Recognize maternal or fetal

problems as early as possible
Components of the PARTOGRAPH
• Part 1 = progress of labor
• Part 2 = assessment of maternal
condition
• Part 3 = assessment of fetal
condition
• Part 4 = outcome of labor
Part 1

Progress of Labor
Graph of Cervical Dilatation against
time
➢ Cervicogram area
◦ Graph of cervical dilatation
◦ Each square is 1 cm cervical dilatation
➢ Active phase:
Multipara = 1.5 cm/hr
Primipara = 1 cm/hr
The Alert Line
➢ Drawn from 4 cm to 10 cm
➢ Represents rate of dilatation
-Slow rate of dilatation
indicates delay in labor
 The Action Line
➢ Drawn 4 hrs to the right of the alert line
and parallel to it
➢ Referred to as critical line
➢ If cervical dilatation crosses this line:
-Critical assessment of the cause of
delay
-Decide on appropriate management
should be undertaken
Plotting the Progress of Labor
➢ Plot only the CERVICAL
DILATATION using the symbol “X”
➢ Start when woman is in ACTIVE
LABOR (4 cm or more) and is
contracting adequately (3-4
contractions in 10 minutes)
If plotting passes Alert Line…
➢ Reassess woman and consider criteria for
referral
➢ Alert transport devices
➢ Encourage woman to empty bladder
➢ Encourage upright position and walking if
the woman wishes.
➢ Monitor intensively
➢ If referral takes a long time, refer
immediately.
DO NOT WAIT TO CROSS ACTION LINE.
If plotting reaches the Action Line…
➢ Refer urgently to hospital unless
birth is imminent.
PART 2:

Assessment of
Maternal Condition
• Monitoring q4h:
➢ Drugs
➢ Pulse
➢ Blood pressure
➢ Temperature
➢ Urine volume (yes/no)
Part 3

Assessment of Fetal Condition

Regular monitoring of the ff:
➢ FHR
➢ Membranes and amniotic fluid
-Plotted as follows: “ I ”= Intact membranes
➢ If ruptured, note color of amniotic fluid
“ C ” = Clear
“ A ” = Absent
“ M ” = Meconium-stained
“ B ” = Blood-stained
Part 4:

Outcome of Labor
➢ Based on observations of part
1, 2 and 3 and after delivery
Thank you!