Partogram For Safe Motherhood
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USE OF PARTOGRAM FOR SAFE MOTHERHOOD BY ARTHI.K
PARTOGRAM (COMPOSITE DELIVERY RECORD ) PARTOGRAM IS A COMPOSITE GRAPHICAL RECORD OF CERVICAL DILATATION AND DESCENT OF HEAD AGAINST DURATION OF LABOUR IN HOURS. IT ALSO GIVES INFORMATION ABOUT FETAL AND MATERNAL CONDITION THAT ARE ALL RECORDED ON A SINGLE SHEET OF PAPER.
ADVANTAGES OF PARTOGRAPHY • RECORDING IS CLARIFIED.ALL NECESSARY INFORMATION IS ON ONE SHEET OF PAPER AND ABNORMALITIES ARE RECOGNIZED AT A GLANCE. • LABOUR SAVING IT IS MUCH EASIER TO PLACE APPROPRIATE NUMBERS AND LETTERS ON THE GRAPH THAN TO WRITE A DESCRIPTION IN LONGHAND. • EDUCATIONAL VALUE FOR ALL GRADES OF STAFF.
ADVANTAGES OF PARTOGRAPHY • THE RECORDS ARE MORE OBJECTIVE AND THIS FACILITATES THE TRANSFER OF INFORMATION WHEN STAFF CHANGEOVER OR ASSISTANCE IS SOUGHT. • PREDICTIVE VALUE: THE PROBABLE TIME OF ONSET OF THE SECOND STAGE CAN BE PREDICTED FROM THE SLOPE OF THE ACTIVE PHASE AND THERE IS EARLY WARNING OF IMPENDIND MECHANICAL PROBLEMS. • INTRODUCTION OF PARTOGRAM IN THE MANAGEMENT OF LABOUR HAS REDUCED THE MATERNAL AND FETAL MORBIDITY AND MORTALITY.
COMPONENTS • SHORT HISTORY AND RISK FACTORS. • TIME • FOETAL HEART RATE : THE MEAN BASAL HEART RATE IS CHARTED HALF HOURLY. • CERVICAL DILATATION: THIS IS DETERMINED BY VAGINAL EXAMINATION AND MEASURED IN CENTIMETERS.IT IS PLOTTED BY ‘ x’ AND REPEATED EVERY 2-4 HOURS.
THE CERVICAL DILATATION WAS FIRST PLOTTED BY FRIEDMAN.IT IS A SIGMOID CURVE AND HAS 2 PHASES LATENT PHASE AND ACTIVE PHASE. LATENT PHASE IS FROM 0 - 2.5 CM AND LASTS UPTO 8 HRS IN PRIMI AND 4 HRS IN MULTI. ACTIVE PHASE HAS ACCELERATION PHASE 2.5 - 4 CM PHASE OF MAXIMUM SLOPE 4 - 9 CM DECELERATION PHASE 9 - 10 CM DILATATION OF THE CERVIX AT THE RATE OF 1.2 CM/HR FOR PRIMI AND 1.5 CM/HR FOR MULTI IS SATISFACTORY.
COMPONENTS • DESCENT AND STATION OF HEAD: THE DESCENT IS MEASURED AS FIFTHS OF HEAD ABOVE THE BRIM.THE DEGREE OF DESCENT IS ESTIMATED AT THE TIME OF PELVIC EXAMINATION AND PLOTTED ON CERVICOGRAPH USING ‘o’ • LIQUOR: IF MEMBRANES ARE INTACT RECORD ‘I’ IF FLUID IS CLEAR RECORD ‘C’ IF FLUID IS MECONIUM STAINED RECORD ‘M’
COMPONENTS • CONTRACTIONS:THE FREQUENCY,STRENGTH AND DURATION OF CONTRACTIONS ARE RECORDED ON THE PARTOGRAPH. THE SHADING INDICATES DURATION OF INDIVIDUAL CONTRACTIONS AND NUMBER OF CONTRACTIONS IN A 10 MINUTE PERIOD IS INDICATED BY FILLING IN THE APPROPRIATE NUMBER OF BOXES VERTICALLY.
COMPONENTS • OXYTOCICS: THE CONCENTRATION AND RATE IS INDICATED • OTHER DRUGS AND I.V FLUIDS :ALL DRUGS,DOSAGE AND ROUTE OF ADMINISTRATION ARE RECORDED IN THE APPROPRIATE SPACES • MATERNAL BLOOD PRESSURE AND PULSE RATE • URINE AND TEMPERATURE
PARTOGRAM (COMPOSITE DELIVERY RECORD ) PARTOGRAM IS A COMPOSITE GRAPHICAL RECORD OF CERVICAL DILATATION AND DESCENT OF HEAD AGAINST DURATION OF LABOUR IN HOURS. IT ALSO GIVES INFORMATION ABOUT FETAL AND MATERNAL CONDITION THAT ARE ALL RECORDED ON A SINGLE SHEET OF PAPER.
ADVANTAGES OF PARTOGRAPHY • RECORDING IS CLARIFIED.ALL NECESSARY INFORMATION IS ON ONE SHEET OF PAPER AND ABNORMALITIES ARE RECOGNIZED AT A GLANCE. • LABOUR SAVING IT IS MUCH EASIER TO PLACE APPROPRIATE NUMBERS AND LETTERS ON THE GRAPH THAN TO WRITE A DESCRIPTION IN LONGHAND. • EDUCATIONAL VALUE FOR ALL GRADES OF STAFF.
ADVANTAGES OF PARTOGRAPHY • THE RECORDS ARE MORE OBJECTIVE AND THIS FACILITATES THE TRANSFER OF INFORMATION WHEN STAFF CHANGEOVER OR ASSISTANCE IS SOUGHT. • PREDICTIVE VALUE: THE PROBABLE TIME OF ONSET OF THE SECOND STAGE CAN BE PREDICTED FROM THE SLOPE OF THE ACTIVE PHASE AND THERE IS EARLY WARNING OF IMPENDIND MECHANICAL PROBLEMS. • INTRODUCTION OF PARTOGRAM IN THE MANAGEMENT OF LABOUR HAS REDUCED THE MATERNAL AND FETAL MORBIDITY AND MORTALITY.
COMPONENTS • SHORT HISTORY AND RISK FACTORS. • TIME • FOETAL HEART RATE : THE MEAN BASAL HEART RATE IS CHARTED HALF HOURLY. • CERVICAL DILATATION: THIS IS DETERMINED BY VAGINAL EXAMINATION AND MEASURED IN CENTIMETERS.IT IS PLOTTED BY ‘ x’ AND REPEATED EVERY 2-4 HOURS.
THE CERVICAL DILATATION WAS FIRST PLOTTED BY FRIEDMAN.IT IS A SIGMOID CURVE AND HAS 2 PHASES LATENT PHASE AND ACTIVE PHASE. LATENT PHASE IS FROM 0 - 2.5 CM AND LASTS UPTO 8 HRS IN PRIMI AND 4 HRS IN MULTI. ACTIVE PHASE HAS ACCELERATION PHASE 2.5 - 4 CM PHASE OF MAXIMUM SLOPE 4 - 9 CM DECELERATION PHASE 9 - 10 CM DILATATION OF THE CERVIX AT THE RATE OF 1.2 CM/HR FOR PRIMI AND 1.5 CM/HR FOR MULTI IS SATISFACTORY.
COMPONENTS • DESCENT AND STATION OF HEAD: THE DESCENT IS MEASURED AS FIFTHS OF HEAD ABOVE THE BRIM.THE DEGREE OF DESCENT IS ESTIMATED AT THE TIME OF PELVIC EXAMINATION AND PLOTTED ON CERVICOGRAPH USING ‘o’ • LIQUOR: IF MEMBRANES ARE INTACT RECORD ‘I’ IF FLUID IS CLEAR RECORD ‘C’ IF FLUID IS MECONIUM STAINED RECORD ‘M’
COMPONENTS • CONTRACTIONS:THE FREQUENCY,STRENGTH AND DURATION OF CONTRACTIONS ARE RECORDED ON THE PARTOGRAPH. THE SHADING INDICATES DURATION OF INDIVIDUAL CONTRACTIONS AND NUMBER OF CONTRACTIONS IN A 10 MINUTE PERIOD IS INDICATED BY FILLING IN THE APPROPRIATE NUMBER OF BOXES VERTICALLY.
COMPONENTS • OXYTOCICS: THE CONCENTRATION AND RATE IS INDICATED • OTHER DRUGS AND I.V FLUIDS :ALL DRUGS,DOSAGE AND ROUTE OF ADMINISTRATION ARE RECORDED IN THE APPROPRIATE SPACES • MATERNAL BLOOD PRESSURE AND PULSE RATE • URINE AND TEMPERATURE
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