Content area
Abstract
OBJECTIVES
1. To study the utility of partogram in both primigravida and multigravida.
2. To assess the rate of cervical dilatation in both primigravida and multigravida.
3. To evaluate the role of partogram in preventing prolonged labor.
4. To evaluate the maternal and perinatal outcome, in primigravida and multigravida, by comparing their partogram in labor.
MATERIALS AND METHODS
This observational prospective study involved patients admitted to the labor room in Khaja Banda Nawaz Institute of Medical Sciences, Gulbarga. 200 patients participated in the study who were randomly selected and divided into two groups of 100 each, one group consisted of primigravida while the other group was multigravida after meeting the inclusion and exclusion criteria. The study period was between November 2016 to April 2018.
All patients, spontaneous or induced labor, in first stage active phase of labor with cervical dilatation not more than 7 cms, singleton pregnancy of more than 37 weeks and less than 42 weeks, in cephalic presentation, without any medical or obstetric complications were included. Modified Partogram was used according to WHO guidelines and labor managed accordingly.
RESULT
Mean age group in primi was 22.05 yrs with standard deviation of 2.38 yrs and in multi mean age group was 25.19 yrs with standard deviation of 3.09 yrs. Mean duration of active phase of labor in primi was 2 hrs 12 mins and in multi was 1 hrs and 35 mins from the time of admission into the hospital
Mean duration of second stage of labor in primi was 57 mins and in multi was 35 mins. Out of 100 primigravida 68% had NVD, 1% had outlet forceps. 13% had vacuum application and 18% underwent LSCS. Out of 100 multigravida 86% had NVD, 1% had outlet forceps, 7% had vacuum application and 6% underwent LSCS. In group A in primi 75% had NVD, 0% had forceps, and 5% had vacuum application and 0% LSCS whereas in multi 93% had NVD and 7% had vaccum and NO forceps /LSCS. In group B, in primi 20% had NVD, 4% had forceps, 33% had vacuum application and 43% had LSCS whereas in multi 34% had NVD, 8% had forceps, 8% had vacuum application and 50% LSCS. In group C, in primi 100% had LSCS whereas in multi there were no NVD/Vaccum/ forceps/ LSCS cases. In primi 100% had no maternal complications and in multi 96% had no maternal complications. In primi 96% had no neonatal complications and in multi 97% had no neonatal complications.
CONCLUSION
The partograph can be used to assess the progress of labor and to identify when intervention is necessary. This study has shown that using the partograph can be highly effective in reducing complications from prolonged labor for both the mother and the neonate. It has shown to be effective in preventing prolonged labor, in reducing operative intervention and in improving the maternal and neonatal outcome.
