PARTOGRAM
What is a partogram?
J Obstet Gynaecol Can. 2007 Jan;29(1):27-34 A randomized controlled trial of a
bedside partogram in the active management of primiparous labour.
Department of Obstetrics and Gynaecology, University of Toronto,
Toronto, ON, Canada.
The partogram is a pictorial representation of the progress
of labour, used in an effort to enhance early recognition of dystocia
and help avoid Caesarean section (CS). The objective of this study was
to evaluate the effect of partogram use on the CS and obstetric
intervention rates. We conducted a randomized controlled trial
of use of the partogram in 1932 primiparous women with uncomplicated
pregnancies at term. Patients were randomly assigned to one of two
groups: the standard group, who had the progress of labour charted in
written notes, or the partogram group, whose progress in labour was
recorded using a bedside graphical partogram as well as in written
notes. Outcomes were stratified according to whether labour was
spontaneous or induced and whether membranes were initially intact or
ruptured. The primary outcome was the rate of CS; secondary outcome
measures were rates of obstetric intervention for dystocia.
Objectives:
Methods:
Results:
There was no significant difference between the groups in rates of CS (partogram
24%, standard notes 25%), rates of other interventions, amniotomy,
oxytocin use, or the mean cervical dilatation in labour.
Conclusion:
In
this study, the use of a partogram without a mandatory management of
labour protocol had no effect on rates of CS or other intrapartum
interventions in healthy primiparous women at term.
