Poor partogram use in Dar-es-Salaam perinatal care study.WHO's recommendation of the widespread use of the partogram for all women in labour has been adopted by the Ministry of Health of Tanzania, making its use in labour obligatory at all levels of obstetric ob·stet·ric or ob·stet·ri·cal
Of or relating to the profession of obstetrics or the care of women during and after pregnancy.
pertaining to or emanating from obstetrics. care. A study in 2004 investigated the quality of the use of the partogram in four public hospitals in Dar-es-Salaam by reviewing and recording the details of 367 partograms used to monitor progress of labour, maternal and fetal condition, and by interviewing 20 midwives. There were no partogram guidelines in any of the labour wards. There were high proportions of unrecorded parameters, coupled with sub-standard monitoring of progress of labour that may have played a role in maternal and fetal health outcomes. Of all partograms, 50% had no records of duration of labour. Although cervical dilation This page is about the widening of the cervix during childbirth. For the surgical method, see dilation and curettage
Cervical dilation is the dilation (opening) of the cervix during childbirth. and fetal heart rates fetal heart rate Obstetrics A rate which, in the non-stressed fetus, reflects cardioaccelerator and cardiodecelerator reflexes; analysis of the FHR requires evaluation of a baseline FHR between uterine contractions or periodic changes in the FHR and non-periodic, were recorded in 97% and 94% of partograms respectively, 63% and 91% of these were judged to be sub-standard. Sub-standard monitoring of fetal heart rate was strongly associated with poor fetal outcome (p<0.001). Blood pressure, temperature and pulse rates were not recorded in 47%-76% of partograms. Although all midwives interviewed had had formal training on how to use a partogram, it was not reflected in their performance. Suboptimal Suboptimal
A solution is called suboptimal if a part of the solution has been optimized without regards to the overall objective. documentation of some parameters could hinder early detection of complications, and partly explain poor outcomes. This study indicates that urgent in-service training in use of the partogram, supervisory mechanisms and regular partogram audits are needed to improve management of labour and reduce maternal and perinatal deaths. (1)
(1.) Nyamtena A, Urassa D, Massawe S, et al. Partogram use in the Dares Salaam sa·laam
1. A ceremonious act of deference or obeisance, especially a low bow performed while placing the right palm on the forehead.
2. A respectful ceremonial greeting performed especially in Islamic countries.
tr. perinatal care study. International Journal of Gynecology and Obstetrics obstetrics (ŏbstĕ`trĭks), branch of medicine concerned with the treatment of women during pregnancy, labor, childbirth (see birth), and the time after childbirth. 2008;100:37-40.