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Par To Graph Exercises

1) The document provides information on monitoring labor using a partograph, including key details to record like cervical dilation, fetal position, heart rate and contractions. 2) It includes three case studies, or partographs, showing the monitoring of women in labor over multiple time points. 3) The cases illustrate how the partograph is used to assess labor progression and determine if actions need to be taken to assist delivery or respond to any complications that may arise.

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National Child Health Resource Centre (NCHRC)
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© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd
200 views14 pages

Par To Graph Exercises

1) The document provides information on monitoring labor using a partograph, including key details to record like cervical dilation, fetal position, heart rate and contractions. 2) It includes three case studies, or partographs, showing the monitoring of women in labor over multiple time points. 3) The cases illustrate how the partograph is used to assess labor progression and determine if actions need to be taken to assist delivery or respond to any complications that may arise.

Uploaded by

National Child Health Resource Centre (NCHRC)
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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Maternal and Newborn Health Unit Liverpool School of Tropical Medicine

LSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn Care

Symbols
Usual frequency of examination
Cervix x
Vaginal examination 4 hourly
Head O
Fetal Heart Rate ½ - ¼ hourly
Breech w
Fetal heart rate .

Amniotic fluid

Membranes intact I

Membranes ruptures, clear fluid C


Descent: Abdominal palpation1
Meconium stained fluid M

Blood stained fluid B

Moulding
Sutures apposed +
Sutures overlapped but reducible 2+
Sutures overlapped but not reducible 3+

1. WHO Managing complications in pregnancy and childbirth 1


Maternal and Newborn Health Unit Liverpool School of Tropical Medicine
LSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn Care

Partograph Case 1
Name: Mrs KA
Hospital No.: 462432 XY History
Age (Years): 20 •Lower abdominal pains
Parity: Para 0 +0 •No drainage of liquor
Gestational age 38
(Weeks):
Cervix Membranes/ FHR Contractions
Time Lie Presentation Moulding Descent
(cm) Liquor (/Min.) (/10 Min.)
2 (<20
9am 2cm Intact longitudinal Cephalic 140 o 5/5
seconds)

Questions Time 9am


Pulse rate (/Min.) 90
1. What actions will you take?
Blood pressure
2. How will you look after this woman? 120/80
(mmHg)
Temperature (o C) 37.1o
Maternal and Newborn Health Unit Liverpool School of Tropical Medicine
LSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn Care

Partograph Case 2
Name: Mrs AD
History
Hospital No.: 462432 XY
•Lower abdominal pains for 2 hours
Age (Years): 18 •Drainage of liquor for 1 hour
Parity: Para 2+0
Gestational age (Weeks): 38

Cervix Membranes/ FHR Contractions


Time Lie Presentation Moulding Descent
(cm) Liquor (/Min.) (/10 Min.)

4pm 4cm Intact longitudinal Cephalic 144 0 3/5 3 (35sec. each)

8pm 8cm clear longitudinal Cephalic 146 0 2/5 4 (45 sec. each)

Questions Time 4pm 8pm


Pulse rate (/Min.) 88 90
1. What actions will you take at 4pm? Blood pressure (mmHg) 120/70 120/70
Temperature (o C) 37o 37o
Maternal and Newborn Health Unit Liverpool School of Tropical Medicine
LSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn Care

Partograph Case 2
Name: Mrs AD
History
Hospital No.: 462432 XY
•Lower abdominal pains for 2 hours
Age (Years): 18 •Drainage of liquor for 1 hour
Parity: Para 2+0
Gestational age (Weeks): 38

Cervix Membranes/ FHR Contractions


Time Lie Presentation Moulding Descent
(cm) Liquor (/Min.) (/10 Min.)

4pm 4cm Intact longitudinal Cephalic 144 0 3/5 3 (35sec. each)

8pm 8cm clear longitudinal Cephalic 146 0 2/5 4 (45 sec. each)

Questions Time 4pm 8pm


Pulse rate (/Min.) 88 90
1. What actions will you take at 4pm? Blood pressure (mmHg) 120/70 120/70
2. What actions will you take at 8pm?
Temperature (o C) 37o 37o
Maternal and Newborn Health Unit Liverpool School of Tropical Medicine
LSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn Care

Name:
Hospital No.:
Mrs DG
462432 XY
Partograph Case 3
Age (Years): 19 History
Parity: Para 0 +1 •Lower abdominal pains for 10 hours
Gestational age (Weeks): 38 •No drainage of liqour

Membranes
Cervix FHR Contractions
Time / Lie Presentation Moulding Descent
(cm) (/Min.) (/10 Min.)
Liquor
Intact
6am 5cm longitudinal Cephalic 140 0 4/5 3 (40sec. each)
membranes
Artificial
rupture of longitudinal Cephalic
10am 5cm 146 0 3/5 2 (20sec. each)
membranes:
clear
Cephalic
12pm (noon) 8cm clear longitudinal 140 0 2/5 2 (10 sec. each)

longitudinal Cephalic
2pm 9cm clear 144 0 2/5 2 (20 sec. each)

Time 6am 10am 12pm 2pm


Pulse rate (/Min.) 80 84 88 92
Blood pressure (mmHg) 130/70 130/70 140/70 140/70
Temperature (o C) 37.3o 37 37.5 37.5

Questions 1. What actions are required? 2. When would the next examination be?
Maternal and Newborn Health Unit Liverpool School of Tropical Medicine
LSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn Care

Name:
Hospital No.:
Mrs DG
462432 XY
Partograph Case 3
Age (Years): 19 History
Parity: Para 0 +1 •Lower abdominal pains for 10 hours
Gestational age (Weeks): 38 •No drainage of liqour

Membranes
Cervix FHR Contractions
Time / Lie Presentation Moulding Descent
(cm) (/Min.) (/10 Min.)
Liquor
Intact
6am 5cm longitudinal Cephalic 140 0 4/5 3 (40sec. each)
membranes
Artificial
rupture of longitudinal Cephalic
10am 5cm 146 0 3/5 2 (20sec. each)
membranes:
clear
Cephalic
12pm (noon) 8cm clear longitudinal 140 0 2/5 2 (10 sec. each)

longitudinal Cephalic
2pm 9cm clear 144 0 2/5 2 (20 sec. each)

Time 6am 10am 12pm 2pm


Pulse rate (/Min.) 80 84 88 92
Blood pressure (mmHg) 130/70 130/70 140/70 140/70
Temperature (o C) 37.3o 37 37.5 37.5

Questions 1. Comment on the partograph. What actions are required? 2. When would the next examination be?
Maternal and Newborn Health Unit Liverpool School of Tropical Medicine
LSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn Care

Name:
Hospital No.:
Mrs DG
462432 XY
Partograph Case 3
Age (Years): 19 History
Parity: Para 0 +1 •Lower abdominal pains for 10 hours
Gestational age (Weeks): 38 •No drainage of liqour

Membranes
Cervix FHR Contractions
Time / Lie Presentation Moulding Descent
(cm) (/Min.) (/10 Min.)
Liquor
Intact
6am 5cm longitudinal Cephalic 140 0 4/5 3 (40sec. each)
membranes
Artificial
rupture of longitudinal Cephalic
10am 5cm 146 0 3/5 2 (20sec. each)
membranes:
clear
Cephalic
12pm (noon) 8cm clear longitudinal 140 0 2/5 2 (10 sec. each)

longitudinal Cephalic
2pm 9cm clear 144 0 2/5 2 (20 sec. each)

Time 6am 10am 12pm 2pm


Pulse rate (/Min.) 80 84 88 92
Blood pressure (mmHg) 130/70 130/70 140/70 140/70
Temperature (o C) 37.3o 37 37.5 37.5

Questions 1. Comment on the partograph. What actions are required? 2. When would the next examination be?
Maternal and Newborn Health Unit Liverpool School of Tropical Medicine
LSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn Care

Name:
Hospital No.:
Mrs DG
462432 XY
Partograph Case 3
Age (Years): 19 History
Parity: Para 0 +1 •Lower abdominal pains for 10 hours
Gestational age (Weeks): 38 •No drainage of liqour

Membranes
Cervix FHR Contractions
Time / Lie Presentation Moulding Descent
(cm) (/Min.) (/10 Min.)
Liquor
Intact
6am 5cm longitudinal Cephalic 140 0 4/5 3 (40sec. each)
membranes
Artificial
rupture of longitudinal Cephalic
10am 5cm 146 0 3/5 2 (20sec. each)
membranes:
clear
Cephalic
12pm (noon) 8cm clear longitudinal 140 0 2/5 2 (10 sec. each)

longitudinal Cephalic
2pm 9cm clear 144 0 2/5 2 (20 sec. each)

Time 6am 10am 12pm 2pm


Pulse rate (/Min.) 80 84 88 92
Blood pressure (mmHg) 130/70 130/70 140/70 140/70
Temperature (o C) 37.3o 37 37.5 37.5

Questions 1. Comment on the partograph. What actions are required?


Maternal and Newborn Health Unit Liverpool School of Tropical Medicine
LSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn Care

Name:
Hospital No.:
Mrs HA
462432 XY
Partograph Case 4
History
Age (Years): 16
•Labour at home for 6 hours
Parity: Para 0 +0 •Membrane ruptured 4 hours before admission
Gestational age (Weeks): 39

Time Cervix Membranes/ Lie Presentation FHR (/Min.) Moulding Descent Contractions
(cm) Liquor (/10 Min.)

Spontaneous Cephalic
10am 4cm L 150 1+ 3/5 3 (30 sec. each)
rupture, clear
2pm 6cm Blood stained L Cephalic 156 2+ 3/5 4 (40 sec. each)

4pm 6cm Meconium stained L Cephalic 164 3 + 3/5 4 (45 sec. each)

Time 10am 2pm 4pm


Pulse rate (/Min.) 80 86 92
Blood pressure (mmHg) 120/70 130/70 130/70
Temperature (o C) 37 37.2 37.2

Questions

1. Plot the information on a partograph.


2. What action will you take?
3. When would you perform the next vaginal examination?
Maternal and Newborn Health Unit Liverpool School of Tropical Medicine
LSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn Care

Name:
Hospital No.:
Mrs HA
462432 XY
Partograph Case 4
History
Age (Years): 16
•Labour at home for 6 hours
Parity: Para 0 +0 •Membrane ruptured 4 hours before admission
Gestational age (Weeks): 39

Time Cervix Membranes/ Lie Presentation FHR (/Min.) Moulding Descent Contractions
(cm) Liquor (/10 Min.)

Spontaneous Cephalic
10am 4cm L 150 1+ 3/5 3 (30 sec. each)
rupture, clear
2pm 6cm Blood stained L Cephalic 156 2+ 3/5 4 (40 sec. each)

4pm 6cm Meconium stained L Cephalic 164 3 + 3/5 4 (45 sec. each)

Time 10am 2pm 4pm


Pulse rate (/Min.) 80 86 92
Blood pressure (mmHg) 120/70 130/70 130/70
Temperature (o C) 37 37.2 37.2

Questions

1. Comment on the partograph


2. When would you perform the next vaginal examination?
Maternal and Newborn Health Unit Liverpool School of Tropical Medicine
LSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn Care

Name:
Hospital No.:
Mrs HA
462432 XY
Partograph Case 4
History
Age (Years): 16
•Labour at home for 6 hours
Parity: Para 0 +0 •Membrane ruptured 4 hours before admission
Gestational age (Weeks): 39

Time Cervix Membranes/ Lie Presentation FHR (/Min.) Moulding Descent Contractions
(cm) Liquor (/10 Min.)

Spontaneous Cephalic
10am 4cm L 150 1+ 3/5 3 (30 sec. each)
rupture, clear
2pm 6cm Blood stained L Cephalic 156 2+ 3/5 4 (40 sec. each)

4pm 6cm Meconium stained L Cephalic 164 3 + 3/5 4 (45 sec. each)

Time 10am 2pm 4pm


Pulse rate (/Min.) 80 86 92
Blood pressure (mmHg) 120/70 130/70 130/70
Temperature (o C) 37 37.2 37.2

Questions

1. Comment on the partograph.


2. What action will you take in a BEOC and CEOC health facility
Maternal and Newborn Health Unit Liverpool School of Tropical Medicine
LSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn Care

Name: Mrs SA Partograph Case 5


Hospital No.: 462432 XY History
Age (Years): 24
•Lower abdominal pains 3 hours
Parity: Para 3+1 •Drainage of liquor 2 hours
Gestational age (Weeks): 39

Time Cervix Membranes/ Lie Presentation FHR (/Min.) Moulding Descent Contractions
(cm) Liquor (/10 Min.)

10am 4cm Spontaneous Cephalic


rupture 2 hours L 140 0 3/5 3 (30 seconds)
ago, clear
2pm 8cm Clear L Cephalic 156 1+ 3/5 3 (40 seconds)
4pm 9cm Clear L Cephalic 120 2+ 1/5 4 (45 seconds)

Questions Time 10am 2pm 4pm


Pulse rate (/Min.) 86 90 92
1. You are called. What would you Blood pressure (mmHg) 130/70 130/70 130/70
do?
2. When will you do another vaginal 37o 37o 37
Temperature (o C)
examination?
Maternal and Newborn Health Unit Liverpool School of Tropical Medicine
LSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn Care

Name: Mrs SA Partograph Case 5


Hospital No.: 462432 XY History
Age (Years): 24
•Lower abdominal pains 3 hours
Parity: Para 3+1 •Drainage of liquor 2 hours
Gestational age (Weeks): 39

Time Cervix Membranes/ Lie Presentation FHR (/Min.) Moulding Descent Contractions
(cm) Liquor (/10 Min.)

10am 4cm Spontaneous Cephalic


rupture 2 hours L 140 0 3/5 3 (30 seconds)
ago, clear
2pm 8cm Clear L Cephalic 156 1+ 3/5 3 (40 seconds)
4pm 9cm Clear L Cephalic 120 2+ 1/5 4 (45 seconds)

Questions Time 10am 2pm 4pm


Pulse rate (/Min.) 86 90 92
1. Comment on the partograph. Blood pressure (mmHg) 130/70 130/70 130/70
2. What action would you take?
37o 37o 37
Temperature (o C)
Maternal and Newborn Health Unit Liverpool School of Tropical Medicine
LSTM/RCOG Life Saving Skills –Essential (Emergency ) Obstetric Care and Newborn Care

Name: Mrs SA Partograph Case 5


Hospital No.: 462432 XY History
Age (Years): 24
•Lower abdominal pains 3 hours
Parity: Para 3+1 •Drainage of liquor 2 hours
Gestational age (Weeks): 39

Time Cervix Membranes/ Lie Presentation FHR (/Min.) Moulding Descent Contractions
(cm) Liquor (/10 Min.)

10am 4cm Spontaneous Cephalic


rupture 2 hours L 140 0 3/5 3 (30 seconds)
ago, clear
2pm 8cm Clear L Cephalic 156 1+ 3/5 3 (40 seconds)
4pm 9cm Clear L Cephalic 120 2+ 1/5 4 (45 seconds)

Questions Time 10am 2pm 4pm


Pulse rate (/Min.) 86 90 92
1. Comment on the partograph? Blood pressure (mmHg) 130/70 130/70 130/70
2. What action will you take?
3. What are the options for delivery? 37o 37o 37
Temperature (o C)

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