The status of maintaining partograms in labor rooms: A case study from District General Hospital- Kalutara

Abstract

Introduction of partograms to labor rooms has made a significant impact on improving perinatal care in Sri Lanka, because it has helped in detecting risk situations early and allowed medical staff intervening promptly. Assessing the current status of maintaining partograms is of utmost importance in finding deficiencies and recommending ways for improvements. This study was designed to describe the status of maintenance of partograms in General Hospital (GH) in Kalutara. A descriptive cross sectional study was done involving all labor rooms in Kalutara GH over a period of three months in 2017. A data sheet was used to collect information related to maintenance and completeness of partrograms. A total of 402 completed deliveries were taken for analysis. Study population had mean age of 30.6 (SD 4.8) years. Majority of mothers were ‘primi’ (n = 281, 69.9%), 48 (11.9%) had past section while 31 (7.7%) deliveries were breech presentations. Commonest antenatal morbidity was pregnancy induced hypertension (n= 40, 9.6%). Among all deliveries, partograms were started in 198 (49.3%) instances. Among mothers who were taken to labor room during day time (from 6.00 am to 6.00 pm) 56.0% (130 out of 232) were monitored by partograms while the corresponding rate during night time was 40.0% (68 out of 170). Parameters related to the progression of labor (cervical dilatation and decent) were satisfactorily marked as in 180 out of 195 partograms. But only in 42 instances, they were continued till end. Recording of parameters pertaining to maternal wellbeing was poor as only in 92 of partograms an attempt was made. But again only for 41 mothers, it was continued till end of labor. Fetal heart rate was documented in 143 of partograms while only in 76 it was continued till end. It can be concluded that using partograms to record important parameters of labor was not satisfactory in comparing with the standard practice. Even among those partograms, much attention was paid on progression of labor while recording of indicators of maternal wellbeing was poor. This warrants raising awareness among labor room staff on importance of starting and maintaining partograms.