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Validity of paperless Partogram – A new simple clinical tool for prevention of prolonged and obstructed labor

Author: 
Dr. Prakash Chandra Mishra and Dr. Lalmohan Nayak
Subject Area: 
Health Sciences
Abstract: 

Paperless partogram is a simple clinical tool, which in a gravid women in active phase of labour, can predict the expected ‘time’ of delivery (ETD) of the baby and also programmes management of labour. This tool was developed by Dr A K Debdas 2006 (India) and is widely quoted in the net. Objective: The objective of this study was to check the validity & effectiveness of Paperless partogram. Materials: A total 436 women of normal singleton pregnancy in “natural spontaneous labour” at 37 weeks to 42 weeks of gestation, were included for the study in prospective manner from the labour unit of VSS Institute of Medical science, Sambalpur, Odisha. During November 2013 to August 2015. The proportion of Primi to Multi was 66.98% : 33.56%. Method: At the very first PV examination in “active phase” of labour ETD was calculated by application of Friedman formula of dilatation of cervix in labour of-1cm/hour and recorded in BOLD letter, The whole procedure is “paperless” and is a split-second ‘mental’ calculation. Result: On matching the ‘actual time of delivery’ with the calculated ETD, it was found that 70.8% of primi & 88.8% of multi delivered before the predicted ETD. Those who (both primi & multi) failed to deliver by their predicted delivery time – they all however delivered by the 4 hours action time point. Conclusion: Paperless Partogram is a highly reliable, simple clinical tool, which effectively manages labour, prevents prolonged & obstructed labour. So Paperless partogram may serve as a valid alternative to the conventional WHO Partogram which is very complex & time consuming.

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