Introduction to the Partograph
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Questions and Answers

What does degree 1 moulding indicate regarding the fetal skull bones?

  • Bones are overlapping and cannot be separated.
  • Bones are just touching each other. (correct)
  • Bones are completely separated and sutures are easily felt.
  • Bones are overlapping but can be separated easily.

    • In which situation should a mother be urgently referred to a health facility during labour?

  • Identification of degree 1 moulding.
  • Detection of a small caput formation.
  • Assessment of normal fetal heart rate.
  • Discovery of +3 moulding with poor progress of labour. (correct)

    • What is the proper documentation scale for measuring moulding on the partograph?

  • 1 to +3.
  • 0 to +3. (correct)
  • 1 to +5.
  • 0 to +5.

    • What does degree 2 moulding signify about the fetal skull bones?

    <p>Bones are overlapping but can be separated with pressure.</p> Signup and view all the answers

    How should caput formation be documented on the partograph?

    <p>It should not be documented on the partograph.</p> Signup and view all the answers

    What does it mean if the sutures are overlapped but reducible?

    <p>This is degree 2 moulding.</p> Signup and view all the answers

    What is indicated by the grade +3 caput formation?

    <p>A large caput formation.</p> Signup and view all the answers

    Why is it important to assess signs of moulding during labour?

    <p>To predict potential obstructed labour.</p> Signup and view all the answers

    What does a finding of +3 moulding indicate during labour?

    <p>Possible uterine obstruction</p> Signup and view all the answers

    How often should contractions be recorded on the partograph?

    <p>Every 30 minutes</p> Signup and view all the answers

    What is the normal fetal heart rate range at term?

    <p>120–160 beats/minute</p> Signup and view all the answers

    Which condition is referred to as persistent fetal bradycardia?

    <p>Fetal heart rate below 120 beats/minute</p> Signup and view all the answers

    What method can be used to assess fetal wellbeing during labor?

    <p>Counting fetal heartbeats every 30 minutes</p> Signup and view all the answers

    What should be done if the fetal heart rate is counted to be below 120 beats/minute?

    <p>Count it more frequently until it stabilizes</p> Signup and view all the answers

    What should be done in case of persistent fetal tachycardia?

    <p>Increase the frequency of fetal heart rate monitoring</p> Signup and view all the answers

    What does the shading on the partograph squares indicate?

    <p>Strength and duration of contractions</p> Signup and view all the answers

    At what cervical dilation does the active phase of the first stage of labor begin?

    <p>4 cm</p> Signup and view all the answers

    What should you do if you initially start a partograph during false labor?

    <p>Discard the partograph and start a new one when true labor begins</p> Signup and view all the answers

    How often should vaginal examinations be carried out during the active phase of labor?

    <p>Every 4 hours</p> Signup and view all the answers

    When should you start recording on the partograph?

    <p>When the labor is in active first stage</p> Signup and view all the answers

    What happens if a woman is still in the latent phase after 8 hours?

    <p>Continue monitoring until labor progresses</p> Signup and view all the answers

    What is the maximum cervical dilation at the end of the active phase of labor?

    <p>10 cm</p> Signup and view all the answers

    Which of the following is true regarding the partograph?

    <p>Findings should be clear for interpretation by others</p> Signup and view all the answers

    What should you do if you need to refer a mother to a higher-level health facility?

    <p>Send the partograph with the referral note</p> Signup and view all the answers

    What should be recorded if the fetal membranes are intact?

    <p>I</p> Signup and view all the answers

    How often should maternal blood pressure be measured during labor?

    <p>Every four hours</p> Signup and view all the answers

    Which type of amniotic fluid indicates potential fetal distress if meconium-stained?

    <p>M3</p> Signup and view all the answers

    When should the woman in labor be referred to a higher health facility for M1 liquor?

    <p>In the latent first stage of labor with a normal fetal heart rate</p> Signup and view all the answers

    How is the fetal heart rate recorded on the partograph when measured less than 30 minutes apart?

    <p>On the back of the partograph</p> Signup and view all the answers

    What does the presence of clear amniotic fluid typically indicate?

    <p>No indication of fetal distress</p> Signup and view all the answers

    What is the maximum interval for recording the maternal pulse during labor?

    <p>Every 30 minutes</p> Signup and view all the answers

    What should be documented if the amniotic fluid is blood-stained?

    <p>B</p> Signup and view all the answers

    What is one benefit of using a partograph during labor?

    <p>It can detect if labor is progressing normally.</p> Signup and view all the answers

    Which of the following indicates good progress of labor on a partograph?

    <p>Steady increase in contraction duration.</p> Signup and view all the answers

    How often should the mother's pulse be measured and recorded on the partograph during normally progressing labor?

    <p>Every 30 minutes</p> Signup and view all the answers

    What fetal heart rate range is considered indicative of fetal wellbeing?

    <p>120-160 beats/minute</p> Signup and view all the answers

    Which of the following is an indicator for immediate referral during labor?

    <p>Cervical dilation to the right of the alert line</p> Signup and view all the answers

    Which of the following would NOT be recorded on a partograph for fetal wellbeing?

    <p>Fetal heart rate fluctuating over 10-minute intervals</p> Signup and view all the answers

    What is the recommended frequency for measuring the mother's temperature during normally progressing labor?

    <p>Every 2 hours</p> Signup and view all the answers

    Which of the following is a sign of poor progress of labor that may require immediate referral?

    <p>Moulding exceeding +3</p> Signup and view all the answers

    What does it mean that Bekelech is a gravida 5, para 4 mother?

    <p>She has had 5 pregnancies, of which 4 resulted in live births.</p> Signup and view all the answers

    What gestational age is indicated by 40 weeks and 4 days?

    <p>Full term</p> Signup and view all the answers

    At what stage of labor is Bekelech currently during her assessment?

    <p>Active phase of first stage labor</p> Signup and view all the answers

    What does a fetal heart rate of 144 beats/minute indicate?

    <p>It is within the normal range for a fetus.</p> Signup and view all the answers

    What monitoring actions should be taken during Bekelech's labor?

    <p>Begin regular monitoring of labor progress and fetal wellbeing.</p> Signup and view all the answers

    How often should vaginal examinations be conducted in Bekelech's case?

    <p>More frequently than every four hours due to quick progression.</p> Signup and view all the answers

    What station indicates that the fetal head is not yet engaged?

    <p>-3 station</p> Signup and view all the answers

    What is an important consideration for Bekelech given her obstetric history?

    <p>Her previous loss of a baby necessitates close monitoring.</p> Signup and view all the answers

    Study Notes

    Introduction to the Partograph

    • Maternal mortality in developing countries, including Ethiopia, is often linked to complications during prolonged labor.
    • Common complications include hemorrhage, infection, and obstructed labor.

    The Partograph

    • A partograph is a chart used to monitor labor progress and identify potential complications.
    • It visually tracks key aspects of labor, helping to detect abnormal progress or fetal distress.
    • It aids in timely intervention and ensures both maternal and fetal well-being.

    Key Aspects of the Partograph

    • Key Terms: Key terms related to labor are defined (e.g., gravida, para, contractions).
    • Partograph Applications: The importance of using the partograph for labor progress monitoring is described.
    • Partograph Components: The partograph's components (e.g., patient identification, fetal heart rate, cervical dilation, contractions) and their correct measurement intervals are detailed.
    • Good Labor Progress Indicators: The chart flags good labor progression and signs of both maternal and fetal well-being.

    Using the Partograph

    • Normal vs. Abnormal Progress: The guidelines for recognizing abnormal or normal labor progression are clearly defined.
    • Finding Issues: Ways to identify when things go wrong, and whether to refer patients are detailed.
    • Cervical Dilatation: Interpretation of cervical dilation measurements within the context of the partograph is highlighted.
    • Labor Progress Rate: Measures to detect progression—speed and rate of dilation—using the partograph chart are described.

    Fetal Wellbeing

    • Fetal Heart Rate: The normal range and significance of deviations from normal fetal heart rate are explained.
    • Amniotic Fluid: The importance of noting amniotic fluid color and amount is described.
    • Moulding: Assessment and recording of fetal skull molding on the partograph is described.
    • Fetal Head Descent: Measuring and interpreting fetal head descent using the partograph is outlined.
    • Fetal Distress Indicators: Signs on the partograph that may indicate fetal distress are identified.

    When to Refer

    • Referral Criteria: The conditions under which a laboring woman should be referred to a higher-level facility are specified.
    • False Labour: Distinction between true and false labor and how to manage the situation is explained.
    • Emergency Situations: In the event of an emergency—such as fetal distress or complications during labor—the actions to take and referral criteria are stated.
    • Monitoring Tools: The use of the partograph to identify and document the need for immediate referral is described.

    Maternal Wellbeing

    • Vital Signs: The importance of routinely monitoring maternal vital signs (blood pressure, pulse, temperature, and urine output) is emphasized.
    • Labors Progress: The signs of good progress and slow progression of labor are explained.

    Additional Partograph Points

    • Partograph Use: The use of the partograph in specific scenarios is provided.
    • Important Considerations: The significance of properly recording all observations and measurements on the partograph, and how to interpret them is highlighted.
    • Case Studies: Case study examples to illustrate the use of the partograph are presented.

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    Description

    This quiz covers the vital concept of the partograph in monitoring labor progress. It highlights its role in preventing complications during childbirth, especially in developing countries. Key terms and components related to the partograph are also examined, emphasizing their importance for maternal and fetal health.

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