CARE OF MOTHER, CHILD, & ADOLESCENT LEC

SMU – SHANS
2nd YEAR NURSING
FIRST SEMESTER, 2nd TERM
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PARTOGRAPH
PARTOGRAPH
- A tool to help in management of labor.
- Guides birth attendant to identify women
whose labor is delayed and therefore decide
appropriate action

Progress of Labor

CONDITIONS THAT DO NOT NEED THE USE OF

PARTOGRAPH
Maternal and Fetal
- Antepartum hemorrhage
Well-Being - Severe pre-eclampsia and eclampsia
- Fetal distress
- Previous cesarean section
MONITORING DURING LABOR - Multiple pregnancy
- Malpresentation
PROGRESS OF LABOR - Very premature baby
- Cervical dilatation - Obvious obstructed labor
- Contraction pattern
RECORDING THE FINDINGS IN THE
MATERNAL WELL-BEING PARTOGRAPH
- Pulse, temperature, blood pressure - Start by labeling the record with pertinent
- Urine voided patient identifying information.

FETAL WELL-BEING PLOTTING THE PROGRESS OF LABOR

- Fetal heart rate and pattern - Plot only the CERVICAL DILATATION using
- Color of amniotic fluid the symbol “X”
- Start when woman is in ACTIVE LABOR (4
THE PARTS OF THE PARTOGRAPH
cm or more) and is contracting adequately (3-
- Progress of labor 4 contractions in 10 minutes)
- Maternal and fetal well-being

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CARE OF MOTHER, CHILD, ADOLESCENT LECTURE KRISTINE BALER
CARE OF MOTHER, CHILD, & ADOLESCENT LEC
SMU – SHANS
2nd YEAR NURSING
FIRST SEMESTER, 2nd TERM
_____________________________________________________________________________________________________________________________

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CARE OF MOTHER, CHILD, ADOLESCENT LECTURE KRISTINE BALER
CARE OF MOTHER, CHILD, & ADOLESCENT LEC
SMU – SHANS
2nd YEAR NURSING
FIRST SEMESTER, 2nd TERM
_____________________________________________________________________________________________________________________________

DISTINGUISHING NORMAL FROM

ABNORMAL LABOR PATTERN

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CARE OF MOTHER, CHILD, ADOLESCENT LECTURE KRISTINE BALER
CARE OF MOTHER, CHILD, & ADOLESCENT LEC
SMU – SHANS
2nd YEAR NURSING
FIRST SEMESTER, 2nd TERM
_____________________________________________________________________________________________________________________________

IF PLOTTING PASSES ALERT LINE… - If woman is admitted in LATENT PHASE of

- Reassess woman and consider referral if
facilities are not available to deal with
obstetric emergencies, unless delivery is
imminent
- Alert transport services
- Monitor intensively
IF PLOTTING PASSES ACTION LINE…
- The patient must be already in an EmOC
facility, a decision made about the cause of
slow progress, and appropriate action taken.
labor (less than 4 cm dilated) – record only
other findings (BP, FHT etc.).
- If she remains in latent phase for next 8
hours (labor is prolonged), transfer her to
hospital.
EXERCISES
Indicate whether the progress of labor in the
following partographs are normal or abnormal.

OTHER FINDINGS TO NOTE AND RECORD

DURING I.E.
STATUS OF MEMBRANES, WRITE
- “I” if intact

IF RUPTURED, NOTE COLOR OF AMNIOTIC

FLUID, WRITE
- “C” if clear
- “M” if meconium stained
- “A” if absent
- “B” if bloody

MONITOR EVERY 4 HOURS AND RECORD THE

FINDINGS
- Blood Pressure
- Pulse rate
- Temperature
- Urine voided (yes or no)
o More frequently, if indicated

MONITOR MORE FREQUENTLY AND RECORD

THE FINDINGS
- Number of contractions in 10-minute period
- Fetal heart rate in 1 full minute

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CARE OF MOTHER, CHILD, ADOLESCENT LECTURE KRISTINE BALER
CARE OF MOTHER, CHILD, & ADOLESCENT LEC
SMU – SHANS
2nd YEAR NURSING
FIRST SEMESTER, 2nd TERM
_____________________________________________________________________________________________________________________________

Case 5

Lourdes, G4P2 was admitted at 1 pm today due to

watery vaginal discharge. The cervix was
3 cm, cephalic, intact BOW. BP=120/80, PR=80/min,
T-36.5.

At 5pm, contractions were moderate, 3 in 10 min. IE

showed cervix 4 cm dilated. Vital signs remained the
same.

At 9 pm, your IE showed 6 cm dilated cervix. At 1

am, another IE done showed 8 cm dilated cervix,
meconium-stained fluid. BP-110/70, PR-92/min, T-
37.5, FHT-140/min
Plot the observations in the following cases.

Case 4

Maria, G2P1 was admitted today at 2 am, IE showed

a 5cm dilated cervix, cephalic, intact BOW.
BP=110/70, PR=88/min, afebrile. FHT=140/min.

She had moderate contractions (3 in 10 min). At 6

am, the BOW ruptured with clear amniotic fluid. IE
showed 8 cm dilated cervix. Vital signs were the
same.

At 8 am, cervix was 9 cm. She delivered

spontaneously at 8:30 am. 10 u oxytocin was given IM.
Placenta was delivered complete at 8:35 am.
Case 6

Marites, G1P0 was admitted at 6 pm. BP=120/80, PR-

84/min, T=36.5. FHT=150/min, cervix 5 cm dilated,
(+) BOW. She had 2-3 uterine contractions in 10 min.

After 4 hours, IE showed 7 cm dilated cervix. Vital

signs and FHT were the same.

At 12 am, another IE done showed 8 cm dilated

cervix, negative BOW, clear AF. FHT= 140/min.

Another IE after 2 hours was the same.

FHT=144/min, Vital signs same

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CARE OF MOTHER, CHILD, ADOLESCENT LECTURE KRISTINE BALER
CARE OF MOTHER, CHILD, & ADOLESCENT LEC
SMU – SHANS
2nd YEAR NURSING
FIRST SEMESTER, 2nd TERM
_____________________________________________________________________________________________________________________________

RECAP
- Significance and use of the partograph
- Parts of the partograph and information
contained in it
- Recording or plotting of clinical observations
- Interpretation of the recorded findings and
decision on referral

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CARE OF MOTHER, CHILD, ADOLESCENT LECTURE KRISTINE BALER