USE OF PARTOGRAM FOR

SAFE MOTHERHOOD

BY ARTHI.K
 PARTOGRAM
(COMPOSITE DELIVERY RECORD )

PARTOGRAM IS A COMPOSITE GRAPHICAL

RECORD OF CERVICAL DILATATION AND
DESCENT OF HEAD AGAINST DURATION OF
LABOUR IN HOURS. IT ALSO GIVES
INFORMATION ABOUT FETAL AND MATERNAL
CONDITION THAT ARE ALL RECORDED ON A
SINGLE SHEET OF PAPER.
 ADVANTAGES OF PARTOGRAPHY

• RECORDING IS CLARIFIED.ALL NECESSARY

INFORMATION IS ON ONE SHEET OF PAPER
AND ABNORMALITIES ARE RECOGNIZED AT A
GLANCE.
• LABOUR SAVING IT IS MUCH EASIER TO PLACE
APPROPRIATE NUMBERS AND LETTERS ON
THE GRAPH THAN TO WRITE A DESCRIPTION
IN LONGHAND.
• EDUCATIONAL VALUE FOR ALL GRADES OF
STAFF.
 ADVANTAGES OF PARTOGRAPHY

• THE RECORDS ARE MORE OBJECTIVE AND

THIS FACILITATES THE TRANSFER OF
INFORMATION WHEN STAFF CHANGEOVER OR
ASSISTANCE IS SOUGHT.
• PREDICTIVE VALUE: THE PROBABLE TIME OF
ONSET OF THE SECOND STAGE CAN BE
PREDICTED FROM THE SLOPE OF THE ACTIVE
PHASE AND THERE IS EARLY WARNING OF
IMPENDIND MECHANICAL PROBLEMS.
• INTRODUCTION OF PARTOGRAM IN THE
MANAGEMENT OF LABOUR HAS REDUCED THE
MATERNAL AND FETAL MORBIDITY AND
MORTALITY.
 COMPONENTS
• SHORT HISTORY AND RISK FACTORS.

• TIME

• FOETAL HEART RATE : THE MEAN BASAL

HEART RATE IS CHARTED HALF HOURLY.

• CERVICAL DILATATION: THIS IS DETERMINED

BY VAGINAL EXAMINATION AND MEASURED
IN CENTIMETERS.IT IS PLOTTED BY ‘ x’ AND
REPEATED EVERY 2-4 HOURS.
THE CERVICAL DILATATION WAS FIRST PLOTTED
BY FRIEDMAN.IT IS A SIGMOID CURVE AND HAS 2
PHASES LATENT PHASE AND ACTIVE PHASE.
LATENT PHASE IS FROM 0 - 2.5 CM AND LASTS
UPTO 8 HRS IN PRIMI AND 4 HRS IN MULTI.
ACTIVE PHASE HAS
ACCELERATION PHASE 2.5 - 4 CM
PHASE OF MAXIMUM SLOPE 4 - 9 CM
DECELERATION PHASE 9 - 10 CM
DILATATION OF THE CERVIX AT THE RATE OF 1.2
CM/HR FOR PRIMI AND 1.5 CM/HR FOR MULTI IS
SATISFACTORY.
 COMPONENTS
• DESCENT AND STATION OF HEAD: THE
DESCENT IS MEASURED AS FIFTHS OF HEAD
ABOVE THE BRIM.THE DEGREE OF DESCENT IS
ESTIMATED AT THE TIME OF PELVIC
EXAMINATION AND PLOTTED ON
CERVICOGRAPH USING ‘o’
• LIQUOR:
IF MEMBRANES ARE INTACT RECORD ‘I’
IF FLUID IS CLEAR RECORD ‘C’
IF FLUID IS MECONIUM STAINED RECORD ‘M’
 COMPONENTS

• CONTRACTIONS:THE FREQUENCY,STRENGTH
AND DURATION OF CONTRACTIONS ARE
RECORDED ON THE PARTOGRAPH.
THE SHADING INDICATES DURATION OF
INDIVIDUAL CONTRACTIONS AND NUMBER OF
CONTRACTIONS IN A 10 MINUTE PERIOD IS
INDICATED BY FILLING IN THE APPROPRIATE
NUMBER OF BOXES VERTICALLY.
 COMPONENTS

• OXYTOCICS: THE CONCENTRATION AND RATE

IS INDICATED
• OTHER DRUGS AND I.V FLUIDS :ALL
DRUGS,DOSAGE AND ROUTE OF
ADMINISTRATION ARE RECORDED IN THE
APPROPRIATE SPACES
• MATERNAL BLOOD PRESSURE AND PULSE
RATE
• URINE AND TEMPERATURE