A STUDY ON THE IMPORTANCE OF PARTOGRAPHIC CONTROL OF LABOUR

Dr. Asma Begum*

ABSTRACT

Background: Partographic control of labor involves the use of a partogram, which is a graphical record of the progress of labor. The partogram typically consists of a graph that tracks cervical dilation, fetal heart rate, and uterine contractions over time. Objective: In this study our main goal is to evaluate the importance of partographic control of labour. Method: This is a prospective study was carried out (MAT-1) in the Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital (DMCH), Dhaka from 1" July 2009 to 31" December 2009. 50 Patients who are in 2nd stage of labour were included in my study. Fifty cases, including both primi- and multi-gravidae, who were admitted to Unit-I, Department of Obstetrics and Gynaecology, DMCH, during this period, was taken as the study population. Partographic recording was started for all women in labour. The frequency and strength of uterine contractions were studied half hourly in the active phase and the number of contractions in 10 minutes and strength of contractions were recorded. Results: During the study, 4-5 cm cervical dilatation was found by 70% pt, 20-40 sec uterine contraction was found in 38% pt and frequency of contraction was 3 among 50% pt. FHR was 120-140/min were found in 54% pt. Position of fetus found that 92% cephalic, 58% LOA, 52% head was engaged, half of the membrane was intact and 94% pelvis were adequate. Those who had LUCS among them 40% & 20% due to foetal distress and malrotation respectively where another 40% due to CPD. 40 & 60% neonate was male and female respectively. Mild dep (4-6) was found in 16% neonate within one min where it was only 4% within 5 min. 4-5 cm cervical dilatation was found in 66.7% multi and 71.9% primi pt, where more than 6 cm cervical dilatation was found in 9.4% and 11.1% primi and multi respectively. NVD was found in 62.5% & 83.3% primi and multi respectively. Assisted VD found more (12.5%) in primi than multi (5.6%) pt. Primi pt need more (25%) LUCS than multi (11.1%). Second stage of labour was found below 30 min in majority primi and multi pt (56.2% and 77.8%) where more than 60 min was found in 15.6% primi and 5.6% multi pt. Conclusion: With the use of partogram and its scientific application, the result showed that operative interventions were reduced, duration of labour and no maternal or perinatal mortality. In addition, it reduce the workload of recordkeeping in traditional way.

Keywords: Partographic control, labor, parity.