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