Visual effect of partogram designs on the management and outcome of labour

Abstract

A prospective study of 3 partogram designs was performed in 990 women in labour with singleton pregnancy. Partogram A, B and C showed a progressively flatter steepness of the curve of labour progression. Oxytocin was administered in 35.1% of partogram-A users, 45.9% of partogram-B users (p = 0.001) and 44.1% of partogram-C users (p = 0.035). Significantly fewer patients among the partogram-A users (10.2%) were administered oxytocin too early compared to 18.6% of partogram-B users and 20.5% of partogram-C users. Of those with spontaneous onset of labour, a significantly smaller total dose of oxytocin was administered to the partogram-A users compared to the other 2 groups. Ominous electrocardiotocographic fetal heart patterns were detected less frequently during the first stage of labour in partogram A users (0.4%) compare to partogram-B users (1.1%) and partogram-C users (3.0%). Significantly fewer infants born to partogram-A users had depressed Apgar scores at 1 and 5 minutes. Partograms displaying a flat graph, compared to a steep graph, were more often considered to have a slow progress of labour. Adoption of partograms showing a steep graph of progress of cervical dilatation is recommended.