PARTOGRAPH – It is a graphical presentation of the process of labor in which cervical dilatation and
descent of fetal head is plotted against time ( duration of labor in hours) as well as maternal and fetal
vital paraemters .
SECTIONS IN PARTOGRAPH- on x- axis each box represent half hourand it should be started when
patient entered into active phase of labor.
1.Preliminary data – name, age , parity, Hospital registration number , date and time of admission , date
and time of rupture of membranes.
2. FETAL CONDITION- fetal heart rate plotted every half hourly .
3. LIQUOR – If membranes intact marked “I” if membranes ruptured comment on color of liquor-‘ C’ for
clear, ‘M’ for meconium and ‘B’ for blood stained.
4. CERVICAL DILATATION- to be started from 4 cm dilation on alert line and plotted every 4 hourly .
5. UTERINE CONTRACTIONS- squares are shaded according to the number of contractions per 10 min.
faint for <20 seconds slightly dark for 20-40 seconds and dark for >40 seconds .
6. DRUGS AN INTERVENTION- any drug or iv fluid which is given eg- oxytocin to be marked.
7. MATERNAL CONDITION- Pulse to be monitord every 30 min and BP every 2 hour. Tempaerature
should also be recorded 2 hourly.
LABOUR CARE GUIDE- It is a tool that aims to support good quality, evidencve based, respectful care
during labor and child birth, irrespective of setting or level of health care for a positive child birth
experience for every woman.
1.identifying information and labor characteristics at admission- name, age , parity, Hospital registration
number , date and time of onset of active labor , date and time of rupture of membranes, risk factors.
2. Supportive care- aims to encourage RESPECTFUL MATERNITY CARE which is a fundamental right of
every pregnant women. It includes labor companionship marked Yes (Y) or No (N), Access to
pharmacological or non- pharmacological pain- relief, ensuring women are offered iv fluids and posture
of patient marked MO if mobile or SP if supine .
3. Care of baby-includes marking of baseline fetal heart rate, amniotic fluid as C,M,B. fetal position as
Pasterior(P), TRANSVERSE(T) and anterior(A). caput as +, ++,+++. Moulding as +,++,+++.
4. Care of women – BP, PR, TEMP, Urine proteins and acetone.
5. LABOR PROGRESS- Frequency and duration of contractions- no of contractions and duration of
contractions in 10 min to be written in numerical number. Cervical dilataion and descent of fetal head to
be marked every 4 hourly and to be started at 5cm dilatation. Along with this descent of fetal head is to
be marked as per station of head as -3,-2,-1,0,+1,+2,+3.
6. Medication- any medication , iv fluids or oxytocin to marked on graph .
7. shared decision making – aims to facilitate continuous communication with the woman and her
companion and the consistent recording of all assessments and plans agreed.
ACTIVITY-
1. FILL PARTOGRAPH OF A 26 YEAR OLD G3P2L2 PATIENT NAME RAJNI ADMITTED IN LABOR
ROOM ON 10/7/22 AT 10PM WITH COMPLAIN OF PAIN ABDOMEN WITH LEAKING PER
VAGINUM SINCE 6PM ON 10/7/22. ON EXAMINATION – BP- 124/80, PR-88/min , Temp- 98.4,
per abdomen – uterine contractions present 2 contactions with duration of< 20 seconds in 10
min , fetal heart rate – 148bpm , per vaginum – 4cm ,30-40% effaced , soft , central , station -2,
membranes absent , liquor clear.
Liquor CLEAR throughout the labor.
TIME FETAL MATERNAL MATERNAL CONTRACTIONS PER TEMP STATION
HEART PULSE BP NUMBER AND VAGINUM OF
RATE DURATIONS FETAL
HEAD
10;30PM 148 88 124/80 2 <20sec 4cm 98.4 -2
11PM 144 74 3<20sec 98.4
11;30PM 142 78 3<20sec 98.4
12AM 140 76 3 ,20-40sec 98.4
12;30AM 138 86 120/76 3 ,20-40sec 98.4 -1
1AM 148 84 3 ,20-40sec 98.4
1;30AM 150 80- 4 ,20-40sec 98.4
2AM 132 94 4, >40 sec 8cm 98.4
2;30AM 138 90 118/78 4, >40 sec 98.4 0
3AM 136 88 4, >40 sec 98.4
3;30AM 134 82 5, >40 sec 98.4
4AM 128 92 5, >40 sec Fully 98.4 +2
dilated
4;30AM 130 94 116/76 5,>40 sec 98.4
TIME COMPANION PAIN ORAL CAPUT MOULDING
RELIEF FLUIDS
10;30PM Y N Y N N
11PM
11;30PM Y N Y
12AM
12;30AM Y Y N
1AM
1;30AM Y Y N
2AM N +
2;30AM Y N N
3AM
3;30AM Y Y Y
4AM + +
PATIENT DELIVERED A SINGLE ALIVE MALE BABY WITH AT 4:30 AM .
2. Fill the labour care guide of same patient with pv at 10:00 pm - 5cm at 2am - 8 cm and full
dilated at 4 am
