SIGNIFICANCE OF WHO MODIFIED PARTOGRAPH IN MANAGEMENT OF SPONTANEOUS LABOUR IN PRIMIGRAVIDAS

Abstract

Introduction: The importance of partogram is to prevent the maternal and perinatal complications. The WHO 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 spontaneous labour in primigravidas.
 Materials and Methods: A cross sectional study of 100 women primigravidas admitted to Jhalawar Medical College from November 2017 to October 2018 with spontaneous onset of labour at term with no high risk factors were recruited for the study using modified WHO Partogram.
 Patients were divided into 3 groups –. 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. Group 3 with women to right of action line was planned.
 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. Augmentation was significantly higher in Group 2 (92.3%) than in Group 1 (67.8%). In the study group, there were no maternal and perinatal deaths.
 Conclusion: The partograph is an inexpensive and easily accessible tool that can effectively monitor the progress of labour. The WHO simplified partograph is highly useful in identifying when to intervene and also reduces perinatal and maternal mishaps.
 Keywords: WHO partogram, Alert line, Maternal outcome, Perinatal outcome