Partograph versus no partograph: effect on labour progress and delivery outcome: a comparative study

Abstract

Background: Abnormal labour which includes prolonged labour and obstructed labour remain major causes of maternal morbidity. The major reason for neonatal mortality, birth asphyxia and subsequent morbidity is essentially the repercussion which occurs when a complicated labour is not intervened at the right time. A Partograph provides a graphic overview of the progress of labour and records information about maternal and fetal condition during labour. It is considered to be a very effective tool to monitor labour progress and prevent prolonged and obstructed labour.Methods: This prospective randomised comparative study was conducted in the Department of Obstetrics and Gynaecology, JLN Hospital and RC, Bhilai, Chattisgarh, from January 2015 to June 2016. Pregnant women were randomly assigned to two groups, of 200 each, after satisfying the inclusion and exclusion criteria. Women assigned to Group 1 had their active labour modified using modified WHO partograph whereas those assigned to Group 2 were not monitored using the partograph.Results: Use of Partograph (group 1) significantly reduced the duration of active phase of labour (p <0.0001), duration of second stage (p <0.0001) and thus the total duration of labour (active phase plus second stage) (p <0.0001). Requirement of augmentation was also significantly reduced (p <0.05). Group 1 also had significantly more spontaneous vaginal deliveries (p <0.01) with lesser requirement of operative interventions like LSCS or instrumental deliveries like forceps. Use of partograph also significantly improved neonatal outcome with significantly lesser newborns with Apgar <7 (p <0.05). However, there was no significant difference between the two groups with regard to NICU admissions (p>0.05).Conclusions: The use of Partograph, when compared to no Partograph plotting in active labour, is associated with better monitoring of labour progress as well as delivery outcome in the form of a healthy mother and a healthy child.

Comparative study on usefulness of modified WHO Partograph in management of labour at one of the rural teaching institutes of Gujarat, India

“…7 Stduy conducted by Ahmed B et al concluded that the duration of first stage and second stage of labour was significantly decreased in the group where partograph was used. 8 Similar findings have been reported in other study too. 9 In present study, rate of NICU admission and its indications were studied in both cases and control.…”

“…7 In the study by Ahmed B et al, there were 91% normal vaginal deliveries in partograph group and 81.5% in other non partograph group. 8 Considering prolonged labour, it was significantly reduced in the group where partograph was used as compared to other group. Around 7.3% of control group had prolonged labour of more than 16 hours in present study while none of the case had such prolong labour.…”

Prevalence and determinants of stillbirth among women attended deliveries in Aksum General Hospital: a facility based cross-sectional study

“…Even in uncomplicated pregnancies there is increased risk in stillbirth associated with maternal age. In older mothers, stillbirth rate increases as the gestational age increases beyond 37 weeks [26].…”

“…Participants who were not served using partograph were in higher odds of facing stillbirth than their counter parts. Poor partograph utilization may resulted in prolonging second stage of labor which could also resulted in depriving interventions like; cesarean section, augmentation and instrumental delivery [26–28].…”

Health care professionals’ adherence to partograph use in Ethiopia: analysis of 2016 national emergency obstetric and newborn care survey

“…The aim of this tool is to alert midwives to abnormalities in maternal or fetal well-being and progress of labour [5]. Moreover, it is a useful tool to prevent prolonged and obstructed labour [6,7]. Even though Cochrane review was not certain on the effect of routine use of partograph to monitor labour [5], the multi-center trial in South East Asia showed a significant reduction in intra-partum still birth, prolonged labour, augmentation, emergency caesarean section and vaginal examination [8].…”