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The cervix should dilate at a rate of 1 cm/ hour or faster.
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other observations on the progress of labour are also recorded on the partograph and are essential features in managment of labour.in hospital settings, moving to the right of alert line serves as a warning for extra vigilance, but the action line is the critical point at which specific management decisions must be made.in health center, the partographs critical function is to give early warning if labour is likely to be prolonged and to indicate that the woman should not be transferred to a hospital (ALERT LINE FUNCTION).The partograph is designed for use in maternity settings, but has a different level of function at different levels of health care.the partograph can be highly effective in reducing complications from prolonged labour for the mother (postpartum hemmorage, sepsis, uterine rupture and its sequelae) and for the newborn(death, anoxia, infections, etc.).
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early recognition of maternal or fetal problems.increase the quality and regularity of all observations of mother and fetus.assist in early decision on transfer, augmentation, or termination or labour.recognize cephalopelvic disproportion long before obstructed labour.early detection of abnormal progess of a labour.Whether used in health centers or in hospitals, the partograph must be accompanied by a program of training in its use and by appropriate supervision and follow up.There is no place for partograph in deliveries at home conducted by attendants other than those trained in midwifery.– Perform vaginal examination in labour and assess cervical dilation accurately – plot cervical dilation accurately on a graph against time The partograph can be used by health workers with adequate training in midwifery who are able to: – observe and conduct normal labour and delivery.Those crossing the nomogram line were found to have a three fold increase in instrumental delivery. On admission in labour, the cervical dilation was assessed and a stencil was used to draw the relevant pencil line of expected progress on the patient's cervicograph which was then completed. The curves were transcribed onto acrylic stencils. Five separate patterns representing normal labour progression were constructed. Curves showing the average course of cervical dilation were constructed for various dialation on admission. These stencils predicted the expected pattern of progression of labour based on the extent of dilation achived by the time the patient is admitted (zero time). The action line was subsequently drawn two hours to the right of the altert line.Action line drawn four hours to the right of the alert line showing that if the patient has crossed the alert line active management should be instituted within 4 hours, enabling the transfer of the patient to a specialised tertiary care centre. Alert line was drawn at a slope of 1 centimetre/hr for nulliparous women starting at zero time i.e. The alert line represented the mean rate of progress of the slowest 10% of patients in the African population whom they served. The aim of this study was to fulfill the needs of paramedical personnel practising obstetrics in Rhodesian African primigravidae. in 1973 introduced the concept of "ALERT" and "ACTION" lines.Plotting cervical dilation against time yielded the typical sigmoid or 'S' shaped curve and station against time gave rise to the hperbolic curve. The time onset of labour was based on the patient's subjective perception of her contractility. History of Partogram Friedman's partogram devised in 1954 was based on observations of cervical dilatation and foetal station against time elapsed in hours from onset of labour. It was developed and extensively tested by the world health organization WHO.For progress of labour and salient conditions of the mother and fetus.A partograph is a graphical record of the observations made of a women in labour.Rass el barr central hospital anddumya specialised hospital.