Division of Reproductive Health

Partograph Case Studies

DRH/ MOH

Division of Reproductive Health

 Emergency Obstetric Newborn Care Harmonised Training

Symbols Usual frequency of examination

Cervix x
Vaginal examination 4 hourly
Head O
Breech w Fetal Heart Rate ½ - ¼ hourly

Foetal heart rate

Contractions: Palpate abdomen (uterine fundus) over
10 min.
Amniotic fluid
Mild < 20 seconds
Membranes intact I
Moderate 20-40 seconds
Membranes ruptures, clear fluid C
Strong > 40 seconds
Meconium stained fluid MS
Blood stained fluid BS
Descent: Abdominal palpation11
Moulding
Sutures apposed +
Sutures overlapped but 2+
reducible
Sutures overlapped but not 3+
reducible
Division of Reproductive
3 and childbirth
1. WHO Managing complications in pregnancy Health
 Partograph Case 1
Emergency Obstetric Newborn Care Harmonised Training

Name: Mrs KA
History
Hospital No.: 462432 XY
•Lower abdominal pains
Age (Years): 20 •No drainage of liquor
Parity: Para 0 + 0
Gestational age 38
(Weeks):

Contraction
Cervi Membranes/ FHR
Time Lie Presentation Moulding Descent s
x (cm) Liquor (/Min.)
(/10 Min.)

longitudin 2 (<20
9am 2cm Intact Cephalic 140 o 5/5
al seconds)

Time 9am
Questions Pulse rate (/Min.) 90
1. What actions will you take? Blood pressure
(mmHg) 120/80
2. Will you offer pain relief?
3. What options for pain relief would you use? Temperature (o C) 37.1o

Division of Reproductive Health

 Emergency Obstetric Newborn Care Harmonised Training Partograp
h Case 2
Name: Mrs AD
Hospital No.: 462432 XY History
•Lower abdominal pains for 2 hours
Age (Years): 25 •Drainage of liquor for 1 hour
Parity: Para 2+0
Gestational age 38
(Weeks):

Cervi Membran
Tim Presenta FHR Mouldi Desce Contractions
x es/ Lie
e tion (/Min.) ng nt (/10 Min.)
(cm) Liquor
4p longitudin 3 (35sec.
5cm Clear Cephalic 144 0 3/5
m al each)
8p 4 (45 sec.
9cm clear longitudin 146 + 2/5
m Cephalic each)
al

Time 4pm 8pm

Questions
Pulse rate (/Min.) 88 90

Blood pressure
What actions will you (mmHg)
120/70 120/70

take? Temperature (o C) 37o 37o

(at 4pm and at 8pm)
Division of Reproductive Health
 Partograph
Emergency Obstetric and Newborn care Training case 3

Name: Mrs HA
Hospital No.: 462432 History
XY
•Labour at home for 6 hours
Age (Years): 16 •Membrane ruptured 4 hours before
Parity: Para 0 +
admission
0

Gestational age 39
Time Cerv
(Weeks): Membranes/ Lie Presentat FHR Moulding Descent Contractions
ix Liquor ion (/Min.) (/10 Min.)
(cm)
10a Spontaneous Cephalic 3 (30 sec.
5cm L 150 1+ 3/5
m rupture, clear each)
4 (40 sec.
2pm 6cm Blood stained L Cephalic 156 2+ 3/5
each)

Meconium 4 (45 sec.

4pm 6cm L 164 3 + 3/5
stained Cephalic each)
Time 10am 2pm 4pm
Pulse rate (/Min.) 80 86 92
Blood pressure
120/70 130/70 130/70
(mmHg)
Temperature (o C) 37 37.2 37.2

Questions
1. Plot the information on a partograph
Division 2. When would
of Reproductive Healthyou perform the next
vaginal examination? 3. What action will you take in a BEOC and CEOC health
facility?
 Partograp
Emergency Obstetric and Newborn Care Training h Case 4
Name: Mrs SA
Hospital No.: 462432 XY History

Age (Years): 24
•Lower abdominal pains 3
hours
Parity: Para 3+1
•Drainage of liquor 2 hours
Gestational age (Weeks): 39

Time Cx Membranes/ Lie Presentat FHR Moulding Descent Contractions

(cm) Liquor ion (/Min.) (/10 Min.)
10a 5cm Spontaneous Cephalic
m rupture 2 3 (30
L 140 0 3/5
hours ago, seconds)
clear
2pm 10c Clear Cephalic 3 (40
L 156 1+ 3/5
m seconds)
3pm 10c Clear Cephalic 3 (45
L 120 2+ 1/5
m seconds)

Questions Time 10am 2pm 4pm

Pulse rate (/Min.) 86 90 92
1. You are called. What would Blood pressure
130/70 130/70 130/70
you do? (mmHg)

2. What are the options for

37o 37o 37
delivery? Temperature (o C)

Division of Reproductive Health

Questions/ Comments

Division of Reproductive Health