Role of who modified partograph in management of spontaneous labour in primigravidas

Abstract

Introduction: Pregnancy and child birth though considered as physiological process can become lethal for any woman. Childbirth was considered as rebirth to a woman in olden era. The atmost duty of an Obstetrician is to identify the abnormal events at the earliest, intervene appropriately and avoid the catastrophe. The importance of partogram is to prevent the maternal and perinatal complications. The World Health Organisation has simplified the partogram for its use by skilled birth attendants. Aims and Objectives: To study the progress and outcome of labour using modified WHO partogram in pontaneous labour in primigravidas. Materials and Methods: A cross sectional study of 200 women primigravidas admitted to Sree Siddhartha Medical College from December 2016 to November 2017 with spontaneous onset of labour at term with no high risk factors were recruited for the study using modified WHO Partogram. Augmentation of labour requirement, duration of active labour, mode of delivery, maternal and perinatal outcome were studied. Patients were divided into 2 groups – Group 1 and Group 2. Group 1- cervical dilatation and descent curve falling to the left of the alert line. Group 2- cervical dilatation and descent curve falling to the right of the alert line. Though Group 3 with women to right of action line was planned, there were no patients in group 3.Results: Most women belonged to age group of 21-25 years. The mean gestational age was 38.2 weeks. In Group 1, the mean duration of active phase of first stage of labour was 4.52±0.10 hours, where as it was 5.94±1.46 hours in Group 2. In Group 2, the mean duration of second stage of labour was 45.44±1.94 mins but it was 34.42±16.41mins in Group 1study subjects. Mean rate of cervical dilatation is 1.2 cm/hr. Seventy seven percent had normal delivery, 11% had caesarean delivery and 12% had instrumental delivery. Patient crossing the alert line had longer duration of labour. Augmentation was significantly higher in Group