Role of Partogram in Early Recognition of Cephalo Pelvic Disproportion & Prevention of Obstructed Labour

OBJECTIVE: To study the benefits of using partogram in primigravidae. The study was conducted on 200 primigravidae in labour ward Government Maternity Hospital ,SriVenkateswara Medical college,Tirupati. Progress of labour in primigravidae was monitored with WHO modifed partogram and compared with 200 primigravidae which were not monitored with partogram and who were referred from peripheries. Duration of labour, rate of operative delivery and neonatal outcome was studied in the cases monitored with partogram. The rate of operative delivery, incidence of obstructed labour and other complications were studied in the referred group. The rate of operative delivery. Maternal and neonatal morbidity and mortality was compared in both the groups. The rate of instrumental delivery was 9% in study group and 23% in the cases not monitored by partogram. The rate of LSCS was 4.5% in the study group and 20% in the unmonitored group. No neonatal deaths occurred in partogram applied cases and 3 deaths occurred in cases not monitored by partogram. Two cases went in to obstructed labour in unmonitored group where as it was nil in study group. The Philpott’s alert and action lines on cervicograph appeared to be an appropriate indicator for early recognition of abnormal labour and helps in the prevention of maternal and neonatal morbidity and mortality. CONCLUSION: Usage of Partogram with necessary interventions in the study group has resulted in less no. of operative deliveries and good neonatal outcome without any neonatal deaths. In spite of MCH services, we are getting referrals in stages of obstruction from peripheral centres. So, training of birth attendants, nurses , midwives and basic doctors in the usage of Partogram helps in identifying labours which are abnormal and thereby helps in timely referral and intervention. The value of Partogram in our setup cannot be ignored.