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4: Y4 - Obstetrics [13] > [36] Partograms > Flashcards

[36] Partograms Flashcards

1
Q

What is a partogram?

A

A single sheet of paper on which there is a graphic representation of progress in labour

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2
Q

What things care recorded on a partogram?

A
  • Frequency and duration of contractions
  • Fetal heart rate
  • Colour of liquor
  • Caput and moulding
  • Station or descent of head
  • Maternal heart rate, BP and temp
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3
Q

What is the purpose of a partogram?

A

To enable early recognition of labour that is non-progressive

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4
Q

When should a partogram be started?

A

As soon as the mother is admitted to the delivery suite

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5
Q

What is the time of admission to delivery suite recorded as on a partogram?

A

Zero time

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6
Q

What does the point of entry onto a partogram depend on?

A

Vaginal assessment at the time of admission

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7
Q

How does the partogram help prevent serious obstruction?

A

It draws visual attention to any aberration from normal progress of labour

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8
Q

What can prevention of serious obstruction due to partogram use lead to a reduction in?

A
  • Uterine rupture
  • Sepsis
  • Post-partum haemorrhage
  • Vesico or rectovaginal fistula
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9
Q

Where is the reduction of obstetric complications due to partogram use particularly prominent?

A

Africa

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10
Q

What parameters of the partogram help to give an indication of the fetal condition?

A
  • Fetal heart rate
  • Time of rupture of membranes
  • Nature of amniotic fluid
  • Moulding of fetal head and presence of caput
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11
Q

How are decelerations of the fetal heart rate recorded on the partogram?

A

As an arrow down to the lowest heart rate recorded on the partogram

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12
Q

What are partogram records of fetal heart rate an adjunct to?

A
  • Recording of auscultated FHR in notes

- Electrical fetal monitoring by CTG

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13
Q

What aspect of the nature of the amniotic fluid is important to record on the partogram?

A

Clear or meconium stained

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14
Q

What do moulding of the fetal head and presence of caput indicate?

A

Possible obctructed labour

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15
Q

What is moulding of the fetal head classified as?

A
  • Suture lines meeting = +
  • Over-riding but reducible with gentle pressure = ++
  • Over-riding but not reducible with gentle pressure = +++
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16
Q

What is caput of the fetal head?

A

Soft tissue swelling of the fetal scalp

17
Q

What partogram parameters give an indication of the progress of labour?

A
  • Rate of cervical dilation
  • Descent of presenting part
  • Nature and frequency of uterine contractions
18
Q

How is the rate of cervical dilation measured?

A

Assessed by vaginal examination on admission and every 3-4 hours during first stage of labour

19
Q

How is rate of cervical dilation plotted on a partogram?

A

In cm along a 0-10 scale on a cervicograph

20
Q

How long is the cervix expected to take to efface and dilate from 0-3cm in multipara?

A

5 hours

21
Q

How long is the cervix expected to take to efface and dilate from 0-3cm in nullipara?

A

8 hours

22
Q

At what rate is the cervix expected to dilate from 3-10cm?

A

Approximately 1cm/hour

23
Q

How is expected progress plotted on the cervicograph?

A

As a line at a rate of 1cm/hour from admission

24
Q

What is the line of expected progress on a cervicograph called?

A

Alert line

25
Q

What is the action line on the cervicograph?

A

A line 2 hours parallel with the alert line used to decide when to actively intervene with ARM or oxytocin infusion

26
Q

How is the descent of the presenting part plotted on the partogram?

A
  • The station of the head is plotted on 0-5 gradation of the partogram OR
  • As the level of the presenting part in cm above or below the ischial spines
27
Q

How is the level of the presenting part relative to the ischial spines recorded?

A

-1, -2, or -3 when above and +1, +2 or +3 when below ischial spines

28
Q

How is the nature and frequency of contractions recorded on the partogram?

A

Shading in the number of contractions per 10 minutes

29
Q

What squares are used to indicate contractions <20 seconds on a partogram?

A

Dotted squares

30
Q

What squares are used to indicate contractions of 20-40 seconds on a partogram?

A

Cross hatched squares

31
Q

What squares are used to indicate contractions of >40 seconds on a partogram?

A

Completely shaded

32
Q

How can frequency and duration of contractions be measured?

A
  • Clinical palpation

- External tocography

4: Y4 - Obstetrics [13] (61 decks)

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