Partograph: A Comprehensive Guide to Monitoring Labor Progress, Summaries of Nursing

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MIDWIFERY I

PARTOGRAPHY

The partogram:

CLASS OBJECTIVES:

At the end of this session the student must be able to :

1. Define common terms related to partograph:

 Pelvic outlet.

 Pelvic brim(inlet).

 Diagonal conjugate.

 Occiput.

Cont: objectives:

2) Describe the partograph:

 The progress of labor (cx dilataion,descent of head, uterine contraction).

 The fetal conditions.

 The maternal condition.

Cont:objectives:

 First stage of labor (cx dilatation, latent phase, active phase)

 Molding

Cont:definitions :

Or

PARTOGRAPH :

Is defined as a graphical record of the progress

of labour and salient features of the mother and fetus.

Cont:definitions:

 LABOR: Is the process by which the foetus,placenta and membranes are expelled out from the uterus.

 LATENT PHASE OF LABOR: Is the early part of the first stage of labour, the cervix dilates from 0 up to 4 cm and the cx softens ( effaced ).

Cont:definitions:

 PELVIC BRIM (inlet): The upper opening of the true pelvis. The rounded opening where the presenting part of the fetus goes into on its way to delivery.

 PELVIC OUTLET: Is the lower opening of the bony cavity. Its diamond in shaped. The most important diameter is intertuberosities which measures 11cm in a normal pelvis.

Cont:definitions of common

terms:

 DIAGNAL CONJUGATE: An internal measurements of the pelvis from the bottom of the pubic arch to sacral promontory,12 - 13cm.

 OCCIPUT: The back of the babies head ,the area over the occipital bone.

 SINCIPUT: The forehead of the fetus.

Cont:definition of common terms:

ENGAGEMENT:

Is said to have occurred when the widest presenting transverse diameter has passed through the brim of the pelvic.

In cephalic presentation this is the bi-parietal diameter and in breech presentation it is the bitrochanteric diameter.

Cont:definitions of common

terms:

 MOULDING: The overlapping of a babies skull bone so the head can fit through the pelvis of the mother. The head is squeezed or compressed to reduce its diameter.

 CAPUT: Is a swelling on the head of the fetus ( caput succedaneum ) due to infiltration of serum and blood into the scalp tissue.

Cont:the parts of the partograph:

2) FETAL MONITORING SECTION.

 Fetal heart rate recorded to monitor fetal condition.

 Liquor or amniotic fluid is observed and recorded as. “C” as clear .and “M” as meconium stained. ‘’I” as intact membrane,”R” as Ruptured membrane.

Cont:the parts of the partograph:

3) MOULDING OBSERVED AND RECODED AS:

 “O” means no moulding

 + means small moulding

 ++ means moderate moulding

 +++ means severe moulding

Cont:the parts of the partograph

c) TIME : recorded as admission time zero time. The actual time of the day is recorded below the hours line.

d)PROGRESS OF LABOR AND CONTRACTION:

The contractions are recorded below the time line, along with cervical dilatation and descent of presenting part, they ball together tell the progress of labour.

Maternal monitoring (condition):

i) Blood pressure, pulse rate and temperature are recorded in the space provided.

ii) Urine amount is recorded every time urine is passed. albumin(protein) and acetone are tested at least once.

iii) medications : oxytocin,intravenous, fluids(infusion) are recorded in the space provided.