Partoram To Ensure Safe Motherhood

USE OF PARTOGRAM TO ENSURE SAFE MOTHERHOOD

What is a partogram? It is a composite graphical record of cervical dilatation and descent of head against duration of labour in hours.

Introduced byFriedman

Why do you need a partogram? • Obstetric emergencies like obstructed labour and prolonged labour account for 12% of maternal mortality in India. • It is important that signs of obstructed and prolonged labour are identified early to ensure safe motherhood.

Progress of labour is monitored by • Cervical dilatation – by vaginal examination • Descent of head – by abdominal palpation • Uterine contractions – frequency every 10 minutes

• • • • •

Per vaginal examination – 4 hours Fetal heart rate – 30 minutes Maternal pulse – 30 minutes Temperature – 4 hours Blood pressure – 4 hours

When to start a partogram? • Started after checking that there are no complications of pregnancy which require immediate action. • If history of maternal complications or signs of obstetric emergencies are present, the patient should be immediately referred to a tertiary care center.

Use of partogram • To identify women whose labour is abnormally slow and who require special attention. • Can monitor other factors like fetal and maternal conditions.

CSSM • Child Survival and Safe Motherhood Programme • Started in 1992

Components • Early registration of pregnancy • To provide minimum 3 ante natal checkups • Universal coverage of all pregnant women with TT immunisation • Advice on food, nutrition and rest.

• Detection of high risk pregnancies and prompt referral • Clean deliveries by trained personnel • Birth spacing • Promotion of institutional deliveries.

• The current RCH Programme introduced in 1997 has integrated all these services.