Management of Labour in Primigravida with Who Modified Partograph

Partograph is an inexpensive tool that serves as an "early warning system" and can assist in early decision making on transfer, augmentation, and termination of labour. The main objectives of the study were to compare length of labour, need of oxytocin augmentation, delivery outcome between two groups, neonatal outcome monitored by APGAR Score and incidence of maternal complications. This was a randomized, prospective, comparative study. Primigarvida, aged 19-28 years, with single live foetus in vertex presentation without any medical and obstetrical complications who have crossed 37 weeks of gestation ,but not post term pregnancies have been included in the study. Results were compared between 500 cases, by using WHO modified partogram (Study group) and 500 cases (control group) by monitoring labour without any partogram. Spontaneous vaginal delivery rate had been significantly increased in study group (p<0.0001), need of labour augmentation with oxytocin found to be reduced in study group. Rate of caesarean section was less in study group. Duration of labour has been significantly shortened in study group (p<0.0001). Fetal outcome was better in study group, monitored with APGAR Score at 1minute and APGAR Score at 5 minute. There was no significant difference in maternal mortality and morbidity found between the two groups. Therefore, WHO modified Partograph is easier to use and is a better option for midwives in primary health care centre and tertiary care centre if attached with referral slip, to take an appropriate decision at its earliest.