Effect of Using the Paperless Partograph Versus the original Partograph on Labor Outcomes in Women's Health Hospital.

Abstract

Background:The paperless partogram refers to monitoring progress of labor and arriving at an accurate decision for intervention to ensure safe delivery. It needs no graph paper, no extra time to do it. Aim: To evaluate the efficacy of using the paperless partograph versus the original partograph on labor outcomes in Women's Health Hospital. Sampling : Random sample of 370 participants. Setting: The study was conducted from April 15th , 2016 to September 30 th , 2016 in Women Health Hospital, Assiut University, Egypt, at reception (emergency ) unit. Design method: quesi-experimental design. Study subjects: This study was randomly assign women into 2 groups. Group (1): was allocated to modified WHO partograph and Group (2): was allocated to paperless partograph. Results : Comparison between studied groups as regards time taken for first stage and second stage revealed a statistical significant difference at P. value (<0.017 & <0.001) respectively. For mode of delivery revealed a statistical significant difference at P. value(<0.0152). For postpartum complications revealed a statistical significant difference at P. value(<0.003).Conclusion: The Paperless partograph was effective positively than the WHO modified partograph in the management of labor. Recommendations: This method should be implemented as essential part of care in all health facilities, and used by all clinical training sites to give trainees (doctors and nurses midwives) an opportunity to use it.

Utility of Paperless Partogram in Labor Management

“…The clinician simply adds 6 h to the time at which the woman becomes dilated to 4 cm to find the alert ETD (when cervical dilation is at 10 cm). The clinician adds 4 h to the alert ETD [6][7][8] to get the action ETD. At the time of the alert ETD, clinicians should be sensitized to the fact that the woman has not yet been delivered and, if the current facility lacks C-section availabilities, make arrangements for transportation to a facility with available emergency obstetric care.…”

“…When dilatation crosses to the right of alert line it is a warning that labor might be prolonged, but it does not signify obstructed labor and does not compromise feto-maternal outcome. However, when action line was crossed, it signifies that action must be taken immediately (WHO) [7][8][9]. FHR, liquor, contraction in 10 min (every 1/2 h), BP, temperature (1 hourly), PV examination 4 hourly to see dilation of the cervix and descent and molding of head.…”