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The Partograph
Partograph
• Use partograph to monitor progress of labour at all women admitted to labour ward
• Women should not be admitted for labour ward until in active labour
• Active labour is when women have regular contractions (3-5 in ten minutes) and cervix is 4 cm. dilated
Fetal Heart Rate:
• Assess after contraction for 60 seconds:
• Each 30 minutes in first stage (each 15 minutes if risk factors are identified
• Each 5 minutes when pushing
Cervical Dilatation
• Assessed each 4 hours (or before if a crossed action line is anticipated)
Alert Line:• Start recording cervical dilatation in the alert line.• As long as dilatation is 1 cm or more/hr the alert
line is not crossed.• If cervical dilatation is < 1 cm/hr the alert is
crossed and causes of prolonged labour should be considered: always consider: artificial rupture of membranes and augmentation with oxytocin.
Cervical dilatation
Action Line:
• If the action line is crossed the actions should be as follows in mentioned order (if not already performed)
• ARM and oxytocin augmentation
• Correction of malposition
• Cesarean Section or Vacuum (if in second stage and descend is 1/5 or below)
Amniotic fluid:
I= Intact Membranes
C= Clear
M= Meconium stained
B= Blood stained
Remember: the diagnosis “cephalopelvic disproportion” cannot be made with intact membranes!
Contractions:
Chart every 30 minutes
Number/10 minutes and Duration
• Weak: Lasting <20 seconds Medium: Lasting 20-40 seconds Strong: Lasting >40 seconds
Oxytocin:
• Record oxytocin (amount/volume) and drops / minute