Is partograph being correctly filled or just giving false security

Abstract

Context : Retrospective study was carried out to answer whether or not the partographs that are used to monitor mothers in labour are recorded to the standard. A fuller understanding of this process will be important to educate further the personnel filling the partograph and also to make policies and strategies in the provision of maternity care services. Objectives :

1. To determine whether the partographs are correctly being filled
2. To find out which part of the partograph is not being properly filled. Methods : 100 case records of women delivered in Kasturba Hospital and monitored by partograph, were randomly selected from a period of January May 2015 (20 records per month) and retrospectively studied by a team of 2 assessors. After defining inclusion and exclusion criteria, data was collected through a pre-tested and structured checklist which was developed, after reviewing literature relevant to the problem under study and standard protocols were defined to identify correctly filled partographs and substandard ones. Results : Overall 69 % of the partographs were correctly filled. Fetal heart rate was recorded up to the recommended standard in 78(78%) of the partographs reviewed. In 20 (20%) moulding of fetal head was not recorded at all. The status of membranes was recorded in 78 (78%). Cervical dilatation was recorded in 96 (96%) of the partographs however, 9(9%) of these records were substandard while it was not recorded in 4(4%). Uterine contraction was not recorded in 10 (10 %) while recorded to the standard in 71(71%). Descent of the presenting part was not recorded in 49(49%). 90 (90%) women had their blood pressure monitored. Post delivery baby notes were recorded in 96 (96%) of the partographs. Conclusion : The present study revealed significant proportions of substandard and unrecorded parameters of labour on the modified WHO partograph. This indicates poor documentation, and perhaps monitoring and supervision of labour. Lack and suboptimal documentation of some parameters of the progress of labour could hinder early detection of complications, important to prevent maternal and perinatal mortality and morbidity. Pre-service and periodic on-job training of health workers on the completion of the partograph, regular supportive supervision, provision of guidelines and mandatory health facility policy are recommended.