•PARTOGRAPH

LEARNING OBJECTIVES: That the learners will be able to:

1.Describe the significance of using

partograph in monitoring the progress
of labour, fetal and maternal condition.
2. Describe the frequency of recording
different parameters during labour.

3.Record observations accurately on

the partograph.

4. Interpret a recorded partograph and

recognize any deviation from the
norm.
Partograph is a Greek word which means

“Labour Curve”
• The partograph was originally designed and
used by Prof. R.H. Philpott of Zimbabwe in
1972.
• Later modified and simplified by WHO
DEFINITION:

• Partograph or Partogram is a simple, inexpensive tool which

gives continuous pictorial overview of labour. it is the easy way
to detect prolonged labour.

• A partograph is a graphical record of the observations made of a

women in labour – for progress of labour and salient conditions of
the mother and fetus. ( WHO, 2011 )
FUNCTION:

• The partograph is a vital tool for care providers

who need to be able to identify complications in
childbirth in a timely manner and refer women to
an appropriate facility for treatment.
REASONS FOR US I N G THE
PARTOGRAPH

1. It is an assessmenttool that is easy to use.

• - enables nurses to seeprogress of labor at a glance
on one sheet of paper.
• *replaces lengthy descriptions
REASONS FOR USING THE
PARTOGRAPH
2. Various studies have indicated the advantages of using
thepartograph:
> reduction in number of prolonged labor, labors
requiring oxytocin augmentation and CS.
REASONS FOR USING THE
PARTOGRAPH
3. Assists in early decision on transfer, augmentation
or termination of labor
REASONS FOR USING THE
PARTOGRAPH
• 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
• *There is decrease in maternal mortality and
morbidity owing to obstructed labor.
 • Antepartum hemorrhage
• Severe pre-eclampsia and
eclampsia
Conditions • Fetal distress
that DO NOT • Previous cesarean section
need • Multiple pregnancy
Partogram
• Malpresentation
• Very premature baby
• Obstructed labor
 Component 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
PROGRESS
OF LABOR
GRAPH OF CERVICAL
DILATATION AGAINSTTIME
Cervicogram area
◦ Graph of cervical dilatation
◦ Each square is 1 cm cervical dilatation
◦ Active phase:
Multipara = 1.5 cm/hr
Primipara = 1 cm/hr
ALERT LINE
o Drawn from 4 cmto 10 cm
o Represents rateof dilatation
◦ slow rateof dilatation
◦ Indicatesdelayinlabor
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
Learning Activity 1

Ø Mrs.A. S. was admitted at

9:00 a.m. and the cervix was
4 cm dilated.
Ø At 1:00 pm the cervix was
10 cm dilated
 X

X
9am 1pm
Learning Activity 2

ØMrs. V.Z. was admitted at 12:00

noon and the cervix was 5 cm dilated

Ø At 5:00 pm, the cervix was 9 cm

dilated
 X

12nn 5pm
 PART 2:
• Assessment
of Maternal
Condition
MONITORING
Q4H:

Drugs
Pulse
Blood pressure
Temperature
Urine volume (yes/no)
REGULAR MONITORING OF
THEFHR
FF:
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
 •Based on
observation
PART s of part 1,
4:
Outcome 2 and 3 and
of Labor after
delivery
LEARNING
ACTIVITY 3

At 8:00 a.m., Mrs.V, a 39 years old nulliparous, married from

Cebu City, came in with chief complaints of labor pains and
blood-stained discharge starting at around 3:00 am. Initial
assessment findings are as follows:
> Intact B O W
> 5 cm cervical dilatation, 50% effaced cervix
> Voided freely 5 times; in moderate amount since
onset of uterine contractions
> Frequency of contractions: average of 2-3 x in
10 minutes
> FHR: 134 bpm
> T= 37.20C; PR= 88 bpm;
> BP=120/70 mmHg
Learning Activity 3

AT 12:00 NOON, SUBSEQUENT

ASSESSMENTWAS
• conducted which revealed the following
observations:
> leakage of clear, watery discharge noted
> 9 cm cervical dilatation;100% effaced cervix
• >Voided freely once,in moderate amount
> Frequency of contractions: 3-4x in 10 minutes
> N o changes in maternal vitalsigns
> FHR: 140bpm
LEARNING
ACTIVITY 3

At 1:00 pm., cervix was fully dilated. Mrs. V was

ushered to the D R and positioned comfortably in
the delivery bed, perineal prep done and draped
aseptically. At 1:30 p.m., Mrs. V delivered
spontaneously a healthy baby girl, with A P G A R
score = 9,10. Oxytocin 10 “IU” given IM at right
deltoid at 1:32pm. After five minutes, placenta was
completely delivered, Schultze presentation, with
intact perineum. Uterine massage done, uterus is
firm and well-contracted.
 X

8am
m 12nn 1pm
•THANK YOU

•Ma’am Emm