4-hourly action line on WHO modified partograph, and maternal and neonatal outcomes

Abstract

Background: The partograph is a simple, inexpensive tool to provide a continuous pictorial overview of labor. The goal of this study is to use partograph to monitor labor, initiate uterine activity that is sufficient to produce cervical changes, fetal descent while avoiding uterine hyperstimulation, hypostimulation and fetal distress and provide timely surgical intervention where required. Objectives of the study were to evaluate outcome of labour in terms of action line crossed and augmentation of labour and in whom labour has been managed with 4-hour vs no-hour action line on WHO modified partograph. Methods: Every 8th primigravida mother fulfilling the inclusion criteria was enrolled for the study alternatively for 4 hourly and no partogram reading. Results were compared between Group A, with 50 cases, in whom labour has been managed with WHO modified Partograph with 2-hour action line and Group B, with 50 cases, in whom labour has been managed with that of no action line. Results: The present study shows that more women in 2-hour arm crossed the action line, compared with the no partograph arm, and therefore received more interventions to augment labour. Rate of caesarean section was more in group B than in group A which is statistically nonsignificant. Conclusions: Partograph with 4-hour action line did not show any superiority over that of no partograph line but to be associated with higher incidence of intervention. Further research is required in this field of active management.