A retrospective descriptive study on the use of the partogram in a high-risk referral hospital in the Eastern Cape

Abstract

Background: High maternal and neonatal mortality rates can be reduced by closely monitoring the process of labour and
childbirth. The partogram is a simple, low-cost monitoring tool for intrapartum care, ensuring early detection and intervention in
abnormal labour.
Aim: To describe the utilization of the partogram use and its infl uence on the immediate birth outcomes at Dora Nginza Hospital.
Methods: This was a retrospective descriptive study including maternity fi le records from July to December 2019. Maternal
characteristics, fetal and maternal outcomes, and partogram use were collected. In cases where a partogram was not used,
clinical notes were reviewed to obtain data. Simple descriptive statistics were used to analyse data.
Results: Three hundred-and-one maternal fi les were reviewed. Mean age of mothers was 27.1 years [12 – 47 years], 54.2%
(163/301) were in the age group 21 – 30 years and 28.1% (175/301) were multiparous women. In 82.4% (248/301) of cases
the partogram was used, but only 19.4% were completed correctly. Common errors were: duration of labour in 23.0% (57/28)
cases, maternal vitals 21.0% (52/248) and fetal position 20.2% (50/248). In 56/80 caesarean sections the partogram was used
versus partogram not used in 24/80 caesarean sections.
Conclusion: Our study showed a high utilization of partogram in a tertiary and teaching hospital, and supported the recent
Cochrane systemic review where utilization of the partogram had no statistically signifi cant association with immediate
neonatal outcome. In our study the majority of caesarean sections were associated with partogram use versus no partogram
use. No association was however found between partogram use and postpartum haemorrhage.