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.
