The Effect of Use of A Modified Type of Partogram on Cesarean Section Rates: A Randomized Controlled Clinical Trial

Abo Elkheir, Mohammed Fawzi; Barakat, Rafik Ibrahim; Abdelhafez, Mohammed Alsayed; Aldakdousy, Kholoud Almosad Gomaa Y

doi:10.21608/ejhm.2022.258476

The Effect of Use of A Modified Type of Partogram on Cesarean Section Rates: A Randomized Controlled Clinical Trial

Document Type : Original Article

Authors

10.21608/ejhm.2022.258476

Abstract

Background: The partograph is an inexpensive tool designed to provide a continuous pictorial overview of labor and has been shown to improve outcomes when used to monitor and manage labor. It is a single sheet of paper which includes information about the fetus' heart rate, uterine contraction, any drugs used and other important factors that could help avoid extensive descriptive notes. The objective of the current study is to detect the value of use of modified type of partogram and comparing it with the classical type of partogram in reducing unindicated cesarean section rate, and to detect obstructed labor early to make earlier decision in management of labor.
Patients and methods: This randomized controlled clinical trial was carried out by simple random sampling using sealed envelopes technique. Partograms were conducted on 140 females with cervical dilatation less than 6 cm, single tone pregnancies, gestation of at least 37 completed weeks, cephalic presentation, and no reported use of oxytocin in the first stage of labor. Thereafter, they were divided into two groups according to the type of partogram used during labor monitoring as the following: Classic partogram with one hour two lines, and WHO 2007 modified type of partogram. Results: Cesarean section rate is lower among group with modified type of partogram than classical one (2.9% versus 12.9%). Mean time of start active phase of labor was earlier and shorter time from entrance in the hospital till labor among group with classical than group with modified partogram.
Conclusion: Modified partogram lowered the incidence of cesarean section rate, compared with classical partogram. Also, mean time of start active phase of labor and duration from admission to delivery were shorter with modified partogram compared with classic partogram. Monitoring and audit of the partogram in practice, including completion, decision making and referral and outcomes, is recommended.

Keywords