How can obstructed labour be diagnosed on the partograph?
Obstructed labour is revealed by recordings on the partograph of the rate of cervical dilatation (which, as you know, should progress at a rate of at least 1 cm per hour) and the rate of fetal head descent.
What are the criteria to say labor is obstructed?
Labor is considered obstructed when the presenting part of the fetus cannot progress into the birth canal, despite strong uterine contractions.
What are the 3 components of the partograph?
Components
- Patient identification.
- Time: It is recorded at an interval of one hour.
- Fetal heart rate: It is recorded at an interval of thirty minutes.
- State of membranes and colour of liquor: “I” designates intact membranes, “C” designates clear and “M” designates meconium stained liquor.
Who partograph is used in labour when?
The partograph is a tool for monitoring maternal and foetal wellbeing during the active phase of labour, and a decision-making aid when abnormalities are detected. It is designed to be used at any level of care.
When using a partograph an alert nurse will determine a difficult labour by the following indication?
Refer the woman to health centre or hospital if the cervical dilatation mark crosses the Alert line on the partograph. When you identify +3 moulding of the fetal skull with poor progress of labour, this indicates labour obstruction, so refer the mother urgently.
What is the difference between prolonged Labour and obstructed labour?
The P’s of prolonged labor are a small passage (pelvis) relative to the passenger (baby) and power (poor contractions). Obstruction occurs when spontaneous delivery cannot be achieved. The causes include cephalo-pelvic disproportion, abnormal presentation or features of the fetus and abnormalities of the genital tract.
When using a Partograph an alert nurse will determine a difficult labour by the following indication?
What is the difference between obstructed labour and prolonged Labour?
Session one starts with explanation of the difference between obstructed and prolonged labor. The P’s of prolonged labor are a small passage (pelvis) relative to the passenger (baby) and power (poor contractions). Obstruction occurs when spontaneous delivery cannot be achieved.
What are the principles of partograph?
It is based on the following principles: The active phase of labour commences at 3 cm cervical dilatation. The latent phase of labour should last not longer than 8 hours. During active labour, the rate of cervical dilatation should be not slower than 1 cm/hour.
What is partogram in labour?
The partograph (sometimes known as partogram) is usually a pre‐printed paper form on which labour observations are recorded. The aim of the partograph is to provide a pictorial overview of labour, and to alert midwives and obstetricians to deviations in maternal or fetal well‐being and labour progress.
How do you manage obstructed labour?
The treatment of obstructed labour may require cesarean section or vacuum extraction with possible surgical opening of the symphysis pubis. Other measures include: keeping the women hydrated and antibiotics if the membranes have been ruptured for more than 18 hours.
When would you not use a partograph?
The most important barriers to use of the partograph are low-resource settings, shortage of human resources, low competence, lack of on-going facilitative supervision, acceptability of the tool and lack of functioning referral mechanisms present major challenge to effective use of the partograph [13].
What are the risk factors of obstructed labour?
The risk factors for obstructed labour were prime parity, use of herbal medicines in labour, being a referral from a lower health facility, as well as having a low fetal heart rate (<120 beats per minute) at enrolment. Having a delivery plan in place, an educated male partner and being married were protective of OL.
Why is partograph important?
The partograph or partogram has been established as the “gold standard” labor monitoring tool universally. It has recommended by the World Health Organization (WHO) for use in active labor [1]. The function of the partograph is to monitor the progress of labor and identify and intervene in cases of abnormal labor.
How do you mark a partograph?
For labour to progress well, dilatation of the cervix should be accompanied by descent of the fetal head, which is plotted on the same section of the partograph, but using O as the symbol….
| Station of fetal head (Figure 4.3) | Corresponding mark on the partograph |
|---|---|
| –4 or –3 | 5 |
| –2 or –1 | 4 |
| 0 | 3 |
| +1 | 2 |
What are the features of partograph?
The partograph is designed for recording maternal identification, fetal heart rate, colour of the amniotic fluid, moulding of the fetal skull, cervical dilatation, fetal descent, uterine contractions, whether oxytocin was administered or intravenous fluids were given, maternal vital signs and urine output.
Should all labor wards use a partogram?
The partograph and the accessory equipment needed for its completion should be provided in all labor wards. Effective supervision by health-care workers/managers with training and clinical experience in partograph use is necessary for sustaining successful implementation.
What is a Bandl’s ring?
Bandl’s ring, also known as a pathological uterine ring, is a constriction between a woman’s thickened upper contractile uterine segment and thinned lower uterine segment (LUS) during parturition [1, 2].
How is obstetric obstructed labour revealed?
Obstructed labour is revealed by recordings on the partograph of the rate of cervical dilatation (which, as you know, should progress at a rate of at least 1 cm per hour) and the rate of fetal head descent. Figure 9.3 (a) shows a partograph record of a normal labour with progressive cervical dilatation and fetal head descent.
What is a partograph in labor and delivery?
Obstructed labor is an important cause of maternal and perinatal mortality and morbidity. The partograph graphically represents key events in labor and provides an early warning system. The World Health Organization partographs are the best known partographs in low resource settings.
Do obstetric care providers use partographs to manage obstructed labor?
Even though a partograph is an instrument that is helpful to manage obstructed labor and prevent prolonged labor with its ramifications, the level of usage and factors affecting utilization of partograph among obstetric care providers was not yet studied in the study area.
Does the partograph contribute to maternal mortality due to prolonged labor?
Results reveal that there is poor knowledge concerning the use of the partograph which most likely contributes to the continued increase in maternal mortality and morbidity due to prolonged labor. The precise timing of medical intervention for women in prolonged labor is the subject of considerable debate.