Utilization of the modified WHO partograph in assessing the progress of labour in a metropolitan area in Ghana

Maternal mortality ratio averages 230 per 100,000 live births in developing countries. Obstructed labour, which is a major cause results from prolonged, neglected labour. The partograph as recommended by the World Health Organization is a graphical tool used to monitor the progress of the first stage of labour, thereby preventing prolonged labour. The partograph has been in use in Ghana since 1989. The study was conducted to ascertain the proportion and correct use of the partograph in monitoring labours in 4 hospitals in a metropolitan area of Ghana. Partograph use for labour monitoring averaged 54% in this study. Midwives formed 90% of birth attendants. For the progress of labour, parameters were monitored to standard in 55-60% of cases. Parameters pertaining to fetal well being were correctly monitored in 30-50%. Maternal well being was monitored to standard in 40% of cases. Apgar scores at 1 and 5 minutes did not differ whether parameters were recorded to standard or not. We conclude from our study that almost half of labour cases were not monitored with the partograph. In those that were monitored with the partograph monitoring to standard was done in 40-60%. Birth attendants either lack the skill in charting the partograph to standard protocols or do not appreciate the use of the partograph in monitoring the progress of labour. In resourcelimited centres in the developing world the use of the partograph to monitor the progress of labour cannot be overemphasized. Skilled attendants at deliveries must therefore be given regular updates on the proper use of the partograph during labours.