The Graphic Display of Labor Events

The Graphic Display of Labor Events

Olufemi T. Oladapo (Olabisi Onabanjo University Teaching Hospital, Nigeria)
DOI: 10.4018/978-1-60566-356-2.ch028
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This chapter introduces the partograph as an essential tool of labour management. It describes the concept of the partograph from its historical perspective and highlights its benefits, practical application in contemporary clinical practice, and current challenges to its universal implementation. It also explores the feasibility of design and incorporation of electronic partograph into teleobstetrics to facilitate remote but skilled birth attendance as one of the ways to tackle the problems of prolonged labour resulting from inequitable distribution of maternity specialists in underserved populations. The author hopes that understanding of the basic concept of the partograph, its practical application, and barriers to its global implementation would reveal research priorities in the subject of partography and guide interested information technologists in the development of appropriate design and usage of partograph in the electronic form.
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Search Strategy For Identification Of Studies

An initial electronic search of MEDLINE from inception to January 2008 was conducted to identify potentially relevant studies. The following algorithm was applied both in MeSH and free text words: partograph OR partogram OR labour curve, cervicograph OR cervicogram, alert line AND action line. The Cochrane Library (Issue 4, 2007) was also searched using the same MeSH and free text words as for MEDLINE. Handsearches of proceedings of major conferences on labour complications, bibliography of relevant articles, reviews and chapters in standard textbooks of obstetrics were also conducted. The list of titles and abstract of articles identified by electronic search were examined and full articles of those considered relevant to the subject of partography were retrieved. All relevant articles were critically appraised irrespective of study methodology and no attempt was made to synthesize findings of studies.

Key Terms in this Chapter

Active Phase of Labour: The second part of the first stage of labour during which the cervix dilates from 3 to 10 cm (full dilatation).

Alert Line: A straight line on the active phase section of the cervicograph that starts at 3 cm cervical dilatation (or more) and extends to the point of expected full cervical dilatation (10 cm) at the rate of 1 cm per hour.

Cervicograph (or Cervicogram): The portion of the partograph that displays cervical dilatation in centimetres plotted against time in hours.

Partograph (or Partogram): A graphic record of all the observations made on a woman in labour the central feature of which is the display of cervical dilatation against time

Latent Phase of Labour: The initial part of the first stage of labour during which the cervix dilates from zero to 3 cm.

Prolonged Labour: Any labour extending beyond 12 hours in the active phase of its first stage regardless of age, parity and race.

Action Line: A straight line on the active phase section of the cervicograph, drawn parallel to, and a number of hours (usually 4 or less) to the right of the Alert line.

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