partogram
DESCRIPTION
PartogramTRANSCRIPT
-
2013 Dr Christopher Mansbridge at www.OSCEstop.com, a source of free OSCE exam notes for medical students finals OSCE revision
Partogram Interpretation
A partogram is used to monitor the active phase of the first stage of labour.
Demographics
Patient: name, DOB, age, parity, allergies, blood group, haemoglobin level
Pregnancy: expected delivery date, preferences/ action plans/ risks, gestation
Partogram: date and time
Observations during partogram
Performed every 30 minutes (except temperature and urinalysis every hour)
Look at:
o Maternal observations
Temperature
Blood pressure
Urinalysis
Pulse
o Fetal heart rate
Look at current observations and trends
o Note responses to fluids/ drugs given
Contractions
Noted over each hour
Look at:
o Frequency
o Strength
o Regularity
Determine the trend
Cervical dilation
PV exam performed every 4 hours
Determine cervical dilation rate (alert line = 1cm/2h primip, 1cm/h multip)
Determine progress through labour
o Note responses to oxytocin
Head descent
PV exam performed every 4 hours
Look at:
o Station of presenting part (progression rate)
o Engagement
o Position moulding caput
o Fifths palpable per abdomen
Determine progress through labour
o Note responses to oxytocin
Liquor
Noted over each hour
Determine if liquor is intact, clear, bloody or meconium is present
Determine when changes occurred
Final birth details
Summary times
o Labour onset
o Rupture of membranes
o Active 2nd
stage
o Birth
-
2013 Dr Christopher Mansbridge at www.OSCEstop.com, a source of free OSCE exam notes for medical students finals OSCE revision
o Placenta delivery
Mechanism of delivery e.g. normal, instrumental, C-section
Position of occiput
APGAR score at 1 min and 5 mins
Estimated blood loss
Summary
Summarise
Identify causes for slow progression (e.g. cephalopelvic disproportion, maternal causes such as fibroids/ cervical stenosis, fetal
malpresentation, primary uterine inertia, drugs and fluids used)
Describe why oxytosin was given and the response
Scoring Systems to be Aware of
Bishop score
A PV exam scoring system to determine if labour is likely to commence spontaneously or induction will be required.
Score 0 Score 1 Score 2 Score 3
Cervical dilation (cm) 0 1-2 3-4 5
Cervical consistency firm medium soft -
Length of cervix (cm) >2 2-1 1-0.5
-
2013 Dr Christopher Mansbridge at www.OSCEstop.com, a source of free OSCE exam notes for medical students finals OSCE revision