Partograph
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
37-2
Partograph
Partograph is a graphical record of
cervical dilatation & descent of the
head against duration of labour in
hours.
It also gives information about
fetal & maternal conditions that are
all recorded on a single sheet of
paper
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
37-3
In cervicograph, the alert line starts at 3cm of
cervical dilatation & ends at 10cm dilatation (at
the rate of 1cm/hr). The action line drawn 3-4
hours to the right & parallel to the alert line.
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
37-4
In a normal labour, the cervicograph (cervical
dilatation) should be either on the alert line or to
the left of it. When it falls on zone 2 it is abnormal
and need to be critically assessed. When it falls on
zone 3 case should be reassessed by a senior
person. Decision is to be made either for
termination of labour (CS) or for augmentation of
labour (amniotomy &/oxytocin)
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
37-5
The components of a partograph are:
1. Patient identification
2. Time -recorded at hourly interval. Zero time for
spontaneous labour is the time of admission in the
labour ward and for induced labour is the time of
induction
3. Fetal heart rate -recorded hourly
4. State of membranes and colour of liquor: to mark ‘I’
for intact membranes, ‘C’ for clear & ‘M’ for
meconium stained liquor.
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
37-6
4. Cervical dilatation & descent of the head
5. Uterine contractions -the squares in the vertical
columns are shaded according to duration and
intensity.
6. Drugs & fluids
7. Blood pressure (recorded in vertical line) at every 2
hours & pulse at every 30minutes
8. Oxytocin-concentration in the upper box and dose
(mIU/min) in the lower box
9. Urine analysis
10. Temperature record
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
37-7
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
37-8
Advantages of a partograph
A single sheet of paper can provide details of
necessary information at a glance
No need to record labour events repeatedly
It can predict deviation from normal duration of labour
early. So appropriate steps could be taken in time
It facilitates handover procedure
Introduction of partograph in the management of
labour has reduced the incidence of prolonged labour
and CS rate.
There is improvement in maternal morbidity, perinatal
morbidity and mortality.
© 2009 The McGraw-Hill Companies, Inc. All rights reserved