Role of partogram in high risk pregnancies: an experience at a tertiary centre

Abstract

Background: Cervical dilatation documented on partogram indicates expected rate of progress of labour and deviations from alert line indicates abnormal progress of labour. Its early detection and timely intervention can reduce fetomaternal morbidity.

Purpose: To study the role of partogram in the management of labouring mothers with high risk pregnancies at a tertiary care centre.

Method: Four hundred primigravidas with high risk pregnancies in active labour (with cervical dilatation ≥ 4 cm) were studied, divided into two groups as Partogram and no Partogram group and each group consisted of 200 patients. In Partogram group, progress of labour was documented on modified WHO partograph along with the notes on progress sheet of case record file while by standard notes only in no Partogram group. Cases included were pregnancy-induced hypertension, gestational diabetes mellitus, cholestasis, hypothyroidism, history of previous one LSCS for trial of labour, postdated pregnancy. Management of labour was standardised using set protocols of intrapartum care followed by analysis of duration of labour, rate of intervention, maternal and perinatal outcomes in both group.

Result: Though percentage of normal vaginal delivery was higher in Partogram group (71.5 %) than no Partogram group (68 %), no statistically significant difference was found between two groups regarding mean duration of active phase of first and second stage of labour, rate of operative vaginal deliveries (partogram 12 % and no partogram 12.5 %) and of caesarean section (Partogram 16.5 %, no Partogram 18.5 %) and perinatal outcome.

Conclusion: In this study, partogram had no significant impact on duration of labour, rate of operative interventions and perinatal outcome following its use in the labour management of high risk pregnancies.