Partograph

Question 1

Partograph was first introduced by ___________________, a Gynecologist from ________________ in _________.

Answer 1

Emmanual A. Friedman; New York; 1955

Question 2

It is a graphical presentation of the labor progress for clinical evaluations

Answer 2

Partograph

Question 3

It gives information about the present fetal and maternal condition that are all recorded on a single sheet of paper.

Answer 3

Partograph

Question 4

Partograph was further modified by ________________ in ____, in which combined details of ____________________ together with information about __________________________________

Answer 4

Philpott and Castle; 1972; progress of labor; fetal and maternal conditions

Question 5

What are the advantages of partograph?

Answer 5

1. It helps to identify at an early stage those women whose labor is progressing slowly.
2. All information related to the progress of labor can be seen in a single sheet of paper.
3. Gives clear picture of the normal and abnormality of the patient’s labor
4. It can predict whether the progress of labor is deviating from what is normally expected so that
   appropriate action could be taken immediately.
5. It saves time and effort of health care workers directly involved in the care of the pregnant woman
6. It facilitates easier endorsement of the progress of labor.

Question 6

Why do we need to use partograph?
World Health Organization requires partograph recording to all women who are about to have a normal delivery without the following conditions:

Answer 6

Antepartal hemorrhage, Severe eclampsia and preeclampsia, Fetal distress, Previous Caesarean section, Multiple Pregnancy, Malpresentation, Premature delivery, Obvious obstructed labor.

Question 7

The partograph should commence during ____________________ of labor

Answer 7

active phase

Question 8

The latent phase of labor should not last __________________________

Answer 8

longer than 8 hours

Question 9

The ________________ of labor should not last longer than 8 hours

Answer 9

latent phase

Question 10

During active phase of labor, the average rate of cervical dilatation _______________________________________

Answer 10

should not be slower than 1cm/hour

Question 11

A lag time of ________________ between slowing of the labor progress and the need for intervention will unlikely compromise the fetus or the woman and may avoid unnecessary intervention

Answer 11

under 4 hours

Question 12

COMPOSITE PARTOGRAPH

Answer 12

1. Fetal well-being
   - FHT
   - Character of amniotic fluid
   - Moulding
2. Labor Progress
   - Dilatation
   - Descent
   - Uterine Contraction
3. Medications:
   - Oxytocin
   - IV fluids and medications
4. Maternal well-being
   - BP, Pulse, Temp.
   - Urine output
   - Urine characteristics

Question 13

Parts of Partograph

Answer 13

• Progress of Labor
• Maternal and fetal well-being

Question 14

are the diagonal lines which travels upward to the point of expected full dilation (10cm) at the rate of 1cm per hour.

Answer 14

alert and action line

Question 15

The alert and action line are the diagonal lines which travels upward to the point of expected full dilation (10cm) at the rate of ___________________.

Answer 15

1cm per hour

Question 16

is parallel to the action line with 4 hours gap from each other

Answer 16

alert line

Question 17

The alert line is parallel to the action line with ____________ gap from each other.

Answer 17

4 hours

Question 18

are designed to warn you to take action quickly if labor is not progressing normally

Answer 18

alert and action line

Question 19

Perform an IE ________________ or more often if necessary, and plot findings each time

Answer 19

every 4 hours

Question 20

Once in the _______________ stage of labor, an IE of every hour is allowed

Answer 20

Transitional

Question 21

Once in the Transitional stage of labor, an IE of ___________ is allowed

Answer 21

every hour

Question 22

Progress of labor is ____________ if the plotting stays on or to the left of the alert line (green zone)

Answer 22

normal

Question 23

Plotting that passes the ______________________ will give you an impression that the labor is progressing slowly and in which appropriate actions can be taken to hasten the progress of labor. (example: Amniotomy)

Answer 23

alert line (yellow zone)

Question 24

Progress of labor is normal if the plotting stays on or to the _______________________

Answer 24

left of the alert line (green zone)

Question 25

If plotting passes the ALERT LINE, Place the patient on ____ except _______ for possibility of ___

Answer 25

NPO; water; CS

Question 26

If plotting passes the ALERT LINE, prepare __________ (If in a BEmONC facility)

Answer 26

EMTS

Question 27

If plotting passes the ALERT LINE, prepare for a possible referral to a _____________________.

Answer 27

CEmONC facility

Question 28

If plotting REACHES THE ACTION LINE, the patient must be transported to a ______________ immediately

Answer 28

CEmONC facility

Question 29

Write “__” if it is intact

Answer 29

I

Question 30

if the fluid is clear

Answer 30

C

Question 31

If meconium stained

Answer 31

M

Question 32

if bloody

Answer 32

B

Question 33

if absent

Answer 33

A

Question 34

If the membranes are ruptured and meconium-stained, the following should be written in the partograph:
M1 for

Answer 34

lightly stained fluid

Question 35

If the membranes are ruptured and meconium-stained, the following should be written in the partograph:
M2 for

Answer 35

a moderately thick fluid

Question 36

If the membranes are ruptured and meconium-stained, the following should be written in the partograph:
M3 for

Answer 36

a very thick, soup-like consistency of the fluid

Question 37

no bleeding assessed/ “spotting” present

Answer 37

0

Question 38

mild bleeding to moderate bleeding

Answer 38

+

Question 39

moderate to severe bleeding/ gush of blood present

Answer 39

++

Question 40

The vital signs and urine output of the woman in labor can be done ________________ if the progress line is within the green zone

Answer 40

every 2-4 hours

Question 41

An ___________ monitoring of vital signs is necessary if the progress line is in the yellow zone.

Answer 41

hourly

Question 42

A _______________ vital signs monitoring is required if it reaches the red zone.

Answer 42

more frequent