Partogram –

maternal and
fetal monitoring
 DEFNITION
The partograph is a graphic
representation used to
assess the progress of labor
and to identify when
intervention is necessary.
 A partograph is used to record all observations made
on a woman in labour .
 The central feature of this is , graph, where
dilatation of the cervix is plotted by assessing the
vaginal examination.
 By noting the rate of cervical dilatation, it is possible
to identify women whose labours are abnormally
slow and who require special attention.
 The partograph is used to plot following parameters
for the progress of labour; cervical dilatation ,
descent of the fetal , and uterine contractions.
 Itis also used for monitoring fetal conditions with
the following parameters fetal heart rate ,
membranes and liquor and moulding of fetal skull.
 Additionally , the partograph can be used to
monitor maternal conditions – pulse , blood
pressure, temperature, urine, drugs, IV fluids, and
oxytocin.
 Vaginal examination is generally done every 2-4
hours . Uterine activity and the heart rate of fetus
is assessed every 15minutes. The findings are
recorded on the graph.
BENEFITS OF USING THE PARTOGRAPH
 Effective means of recording progress of labour.
 Transfer of information becomes easy when labor
status normal.
 Provides the opportunity for early identification
of deviations from normal.
 It serves as a visual means of recording all
observations and includes a pictorial record of the
rate of cervical dilatation.
 It saves the timing of the staff, which can be
wasted in long writings.
 It is the diagramatic representation of the dilatation
of the cervix charted against the hours in labour
 During the first stage of labour, monitoring of
mother and fetus is very important to assure the well
being of both. There are some significant factors
which should be considered during this period.
 Urine testing of the mother is done for gulcose,
proteins, and ketones.
 Vital signs of the mother are assessed at regular
intervals. Pulse rate can be increased during this
stage. Increased metabolism may lead to increase in
respiration. During contractions, blood pressure also
increased.
 One should look for bladder distention. A distended
bladder can cause obstruction in labour. So, the bladder
must emptied every 2-3 minutes.
 Mother may feel tired exhausted. Her general condition
should be monitored to look for signs of fatigue.
 Gastric empting is prolonged during this period . So,
hydration should be maintained by fluids.
 Fetal lie, presentation, position and attitude should be
assessed.
 Fetal heart rate also be monitored regularly, either
externally (by electronic monitoring) or internally (by
scalp electrodes).
Thank you
BIBLIOGRAPHY
•Adele Pillitteri (2003), ‘’Maternal child health nursing care of child bearing sand child
rearing family’’, 5th edition, Philadelphia: Lippincott company. P.no28-30.

•Burns, M.Gravew S.K (1999), “Understanding nursing research,” 3rd edition, W.B Saunders
publication, London. P.no56-59.

•Christopher. J. Carey and Rayburn (1996), “Text book of Obstetric and Gynecology,” 3 rd
edition, New Delhi :Warvey Pvt. Ltd. P.no74- 78.

•Bobak. Jenson (1995), “Maternity and gynaecology care,” 3rd edition, Miscoure Mosby
company. P.no875.

•Corinne. H. (1986), “Normal and therapeutic nutrition,” 7th edition, Mac Millian. P.no187-
190.