Understanding the Partograph in Labor Management

Study Notes

A simple and affordable chart used during labor to track the progress of labor, the condition of both the mother and baby, and the outcome of labor.
Helps detect problems like slow labor or fetal distress early on, allowing for timely intervention.
Recommended by the WHO for routine use in labor management to prevent complications.

Provides a comprehensive overview of labor progress, enabling the identification of potential issues early.
Studies show that utilizing partographs during labor can reduce the occurrence of prolonged labor and associated complications.

Progress of Labor: Tracks cervical dilation against time, utilizing an Alert Line and Action Line to indicate normal or delayed labor.
- Alert Line: Indicates slow labor progression.
- Action Line: Signifies significant delay, requiring immediate intervention.
Maternal Condition: Records maternal vital signs (blood pressure, pulse, temperature), as well as contractions, urine output, and any bleeding.
Fetal Condition: Monitors fetal heart rate (FHR) and records the condition of the amniotic fluid (clear, meconium-stained, etc.).
Outcome of Labor: Documents details such as the time of placental delivery, if oxytocin was administered to aid contractions, and any complications.

Begin using the partograph at the onset of active labor (cervical dilation of 4 cm and regular contractions).
Plot cervical dilation every time an internal examination is performed (usually every 4 hours).
If the plot crosses the Alert Line, evaluate the reason for slow labor.
If the plot crosses the Action Line, take immediate action or refer to a hospital, particularly if birth is not imminent.

Crossing the Alert Line: Reassess the mother and fetus more frequently. Encourage the mother to move, empty her bladder, or change position.
Crossing the Action Line: Take urgent action, such as administering medications or performing procedures, or refer to a hospital, especially if birth is not imminent.

Plot cervical dilation only from active labor (4 cm or more).
Do not wait for the plot to cross into critical zones before acting.
In early labor (less than 4 cm dilation), the mother can be sent home to wait for active labor to begin.