The partograph case tz

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