Role of partogram in preventing prolonged labour.

OBJECTIVE To determine the effect of partogram on the frequency of prolonged labour, augmented labour, operative deliveries and whether appropriate interventions based on the partogram will reduce maternal and perinatal complications. METHOD A case controlled, prospective and interventional study on 1000 women in labour was carried out in the obstetric unit of Jinnah Post graduate medical center, Karachi, from 1st July to 30th December, 2002. Five hundred women were studied before and after the introduction of partogram. Duration of labour, mode of delivery, number of cases augmented and neonatal outcome were noted RESULTS Labour was shorter than 12 hours in 80.8% primigravida, 18.4% had labour shorter than 24 hours and only 0.8% had labour longer than 24 hours. After introduction of partogram 91.6% delivered within 12 hours and rest (8.4%) delivered within 24 hours. Normal vaginal delivery was had in 88%, 5.6% had operative vaginal delivery and 6.4% had caesarean section. Introduction of partogram showed significant impact on duration of labour (p < 0.001) as well as on mode of delivery (p < 0.01). In multigravidae 94.4% delivered within 12 hours and rest 5.6% delivered within 24 hours when partogram was used while 88.4% delivered within 12 hours and the rest 11.6%) within 24 hours before the use of partogram. Partogram showed significant reduction in duration of labour (p < 0.01). Results also showed significant reduction in number of augmented labour (p < 0.001) and vaginal examinations (p < 0.001). CONCLUSION By using partogram, frequency of prolonged and augmented labour, postpartum haemorrhage, ruptured uterus, puerperal sepsis and perinatal morbidity and mortality was reduced.