Partogram Interpretation Flashcards
What is a partogram?
A chart to record the progress of labour together with the maternal and fetal condition
The correct management of a 17-year-old primigravida patient who appears very anxious and complains of painful contractions in early labour is:
The patient must be comforted and reassured and receive appropriate analgesia. If possible, someone she knows should stay with her.
What is the normal maternal temperature during labour?
36.0–37.0 °C
Which of the following indicates that the general condition of a patient in the first stage of labour is normal?
A patient in the first stage of labour will normally appear calm and relaxed between contractions and does not look pale. During contractions, her respiratory rate will increase and she will experience pain. However, she should not have pain between contractions.
Why is maternal pyrexia an important complication during the first stage of labour?
Maternal pyrexia may be caused by an infection which could be dangerous to the patient.
What is the normal maternal pulse rate during labour?
80–100
What causes a rapid maternal pulse during labour?
Fetal distress / Hypertension / Pyrexia / Ketonuria
Pyrexia (also: anxiety, pain, exhaustion, shock)
What would be the best management if a patient’s blood pressure was 90/50 mmHg while she was lying on her back?
The patient must change into the lateral position and the blood pressure measurement should be repeated after a further 1 to 2 minutes.
Ketonuria during labour:
Ketonuria is common in labour and may be normal. However, if a woman has ketonuria, it is important to look for signs of maternal exhaustion.
How do you recognise maternal exhaustion?
The following physical signs may be present:
Tachycardia.
Pyrexia.
A dry mouth.
Oliguria.
Ketonuria.
How should you treat a patient with maternal exhaustion?
If a patient has signs of maternal exhaustion then she should receive:
An intravenous infusion, giving 2 litres of Ringer’s lactate with 5% dextrose. The first litre must be given quickly and the second litre given over 2 hours. It is contra-indicated to give a patient in labour 50 ml of 50% dextrose intravenously as this may be harmful to the fetus.
Adequate analgesia.
Breech presentation, cervix open 2.5cm, no contractions for 20min: Management
Watch and wait (latent phase of labour -> active fase is >3cm)
PROM with GBS positive: Management
IOL (Immediate induction of labour) should be offered + intrapartum antibiotics prophylaxis to prevent neonatal sepsis or meningitis
Pelvic presentation with irregular contractions: Management
Monitor (CTG)
Twin pregnancy, poor contractions: Management
C-section
