1. PARTOGRAM

3. Definition
A partograph is a composite graphical record of cervical dilatation and descent of head against duration of labour in hours

4. Principles
Active phase of labour commences at 3cm cervical dilatation.
Latent phase of labour should not last longer than 8 hours
During active labour, the rate of cervical dilatation should not be slower than 1 cm/hour
Vaginal examination should be performed as frequenlty as once in 2-4 hours
Uterine activity and fetal heart tones are assessed every minutes
It should be used for all women in established labour.

5. History
Friedman (1954)
Hendricks (1969)
Philpott (1972)
WHO (1987)

7. Components of a partograph

8. Identification data

9. Vitals signs of the mother

10. Fetal Heart Rate

11. Membrane and Liquor

12. Cervical Dilatation Latent to active phase Latent phase upto 3cm
Active phase from 3cm
to 10cm

13. Descent of the head

15. Uterine Contractions

16. Oxytocin Regime
Drugs and IV Fluids
Urine volume, output
and Proteins

17. Advantages Useful tool in the labour room
Information in a single sheet
Easy to maintain
Record are straight forward and objective
Facilitates easy handing over
Has a predictive value
Possible to estimate time of delivery
Early warning in case of impending problems

18. Limitations Frequency of examination varies
Difficult for a incompetent personnel to maintain and record
Chances of copying the previous recordings
Deviation from 1cm/hour dilatation rate may be normal