Audit of use of the partograph at the University College Hospital, Ibadan.
Study assessed documentation on the partograph and its influence on decision-making at the University College Hospital (UCH), Ibadan. Partograph records of parturient during 2004 were retrospectively reviewed. Four hundred and forty-five women had partographic monitoring. High-risk patients were more likely to receive closer (quarter-hourly) monitoring than low-risk women (chi2 = 45.7, p < 0.0001). Documentation was high and not influenced by woman's risk or booking status. Descent of presenting part and liquor status were the least recorded parameters. When tracing crossed the alert line (31.2%) or reached the action line (10.1%), augmentation of labour was more often (but not statistically significant) resorted to than emergency Caesarean section. When tracing crossed the action line however, intervention was significantly more likely to be emergency Caesarean section than augmentation of labour (88.2% vs. 11.8%), chi2 = 5.3, p < 0.05. Intervention for inadequate uterine contractions would more likely be augmentation of labour than emergency Caesarean section (81.4% vs. 18.6%), chi2 = 3.9, p < 0.05. This decision was not significantly influenced by the risk status (chi2 = 0.003, p > 0.05). Outcome of labour was favourable for majority of low and high-risk women and their infants. The partograph is universally employed in monitoring of labour at UCH Ibadan. Its use significantly influences decision-making and associated with positive labour outcome among low/high-risk parturient. It is recommended as the sine qua non tool for intra-partum monitoring in all health facilities in Nigeria to reduce maternal complications.
Fawole
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Department of Obstetrics and Gynaecology, University College Hospital Ibadan, Nigeria. fawoleo@yahoo.co.uk
Fadare
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D000293:Adolescent; D000328:Adult; D001034:Apgar Score; D002585:Cesarean Section / Q000706:statistics & numerical data; D003657:Decision Making; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008485:Medical Audit; D009549:Nigeria; D007744:Obstetric Labor Complications / Q000175:diagnosis*; D036801:Parturition; D011247:Pregnancy; D011256:Pregnancy Outcome; D011787:Quality of Health Care; D012189:Retrospective Studies; D012307:Risk Factors