Visual Effect of Partogram Designs on the Management and Outcome of Labour

Summary: A prospective study of 3 partogram designs was performed in 990 women in labour with singleton pregnancy. Partogram A, B and C showed a progressively flatter steepness of the curve of labour progression. Oxytocin was administered in 35.1% of partogram‐A users, 45.9% of partogram‐B users (p = 0.001) and 44.1% of partogram‐C users (p = 0.035). Significantly fewer patients among the partogram‐A users (10.2%) were administered oxytocin too early compared to 18.6% of partogram‐B users and 20.5% of partogram‐C users. Of those with spontaneous onset of labour, a significantly smaller total dose of oxytocin was administered to the partogram‐A users compared to the other 2 groups. Ominous electrocardioto‐cographic fetal heart rate patterns were detected less frequently during the first stage of labour in partogram A users (0.4%) compared to partogram‐B users (1.1%) and partogram‐C users (3.0%). Significantly fewer infants born to partogram‐A users had depressed Apgar scores at 1 and 5 minutes. Partograms displaying a flat graph, compared to a steep graph, were more often considered to have a slow progress of labour. Adoption of partograms showing a steep graph of progress of cervical dilatation is recommended.

[1]  M. Foley,et al.  Active Management of Labor as an Alternative to Cesarean Section for Dystocia , 1984, Obstetrics and gynecology.

[2]  S. M. Garland,et al.  Plastic wrap for ultrasound transducers. Herpes simplex virus transmission. , 1989, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[3]  R. H. Philpott,et al.  CERVICOGRAPHS IN THE MANAGEMENT OF LABOUR IN PRIMIGRAVIDAE , 1972, The Journal of obstetrics and gynaecology of the British Commonwealth.

[4]  J. Studd Partograms and Nomograms of Cervical Dilatation in Management of Primigravid Labour , 1973, British medical journal.

[5]  M. Turner,et al.  Active Management of Labor Associated With a Decrease in the Cesarean Section Rate in Nulliparas , 1988, Obstetrics and gynecology.

[6]  J. Kaldor,et al.  Patient-to-patient transmission of HIV in private surgical consulting rooms , 1993, The Lancet.

[7]  K. O'driscoll,et al.  ACTIVE MANAGEMENT OF LABOUR AND CEPHALOPELVIC DISPROPORTION , 1970, The Journal of obstetrics and gynaecology of the British Commonwealth.

[8]  J. Studd,et al.  Predictive value of cervimetric labour patterns in primigravidae , 1982, British journal of obstetrics and gynaecology.

[9]  J. Thornton,et al.  Effect of presentation of partogram information on obstetric decision-making , 1992, The Lancet.

[10]  D. Mathews Holding back the tide of caesareans. , 1988, BMJ.

[11]  A. Kurjak,et al.  Influence of a partograph on the active management of labour. , 1972, Lancet.

[12]  Philpott Rh,et al.  Cervicographs in the management of labour in primigravidae. II. The action line and treatment of abnormal labour. , 1972 .