THE PARTOGRAPH

Partograph is a graphic that use for monitoring the 1st stage of the labor. The WHO partograph has been modified to make it simpler and easier to use. Thelatent phase has been removed, and plotting on the partograph begins in the active phase when the cervix is 4 cm dilated. Record the following on the partograph:

Patient information: Fill out name, gravida, para, hospital number, date and time of admission, and time of ruptured membranes OR time elapsed since rupture of membranes (if rupture occurred before charting on the partograph began).
Fetal heart rate: Record every half hour.
Amniotic fluid: Record the color of amniotic fluid at every vaginal examination: I: membranes intact; R:membranes ruptured; C: membranes ruptured, clear fluid; M: meconium-stained fluid; B: blood-stained fluid.
Molding: 1: sutures apposed; 2: sutures overlapped but reducible; 3: sutures overlapped and not reducible.
Cervical dilation: Assessed at every vaginal examination and marked with a cross (X). Begin plotting on the partograph at 4 cm.
Alert line: A line starts at 4 cm of cervical dilation to the point of expected full dilation at the rate of 1 cm per hour.
Action line: Parallel and 4 hours to the right of the alert line.
Descent assessed by abdominal palpation (Figure 4-1, below): Refers to the part of the head (divided into five parts) palpable above the symphysis pubis; recorded as a circle (O) at every abdominal examination. At 0/5, the sinciput (S) is at the level of the symphysis pubis.
Hours: Refers to the time elapsed since onset of active phase of labor (observed or extrapolated).
Time: Record actual time.
Contractions: Chart every 30 minutes; count the number of contractions in a 10-minute time period, and their duration in seconds.
Less than 20 seconds:
Between 20 and 40 seconds:
More than 40 seconds:
Oxytocin: Record the amount of oxytocin per volume IV fluids in drops per minute every 30 minutes when used.
Drugs given: Record any additional drugs given.
Pulse: Record every 30 minutes and mark with a dot (ﾁœ).
Blood pressure: Record every 4 hours and mark with arrows.
Temperature: Record every 2 hours.
Protein, acetone, and volume: Record when urine is passed.