Assessment of partogram filling practices and its associated effect on labour outcome to low-risk pregnant women delivering at Amana hospital, ilala Municipality, Dar es salaam, Tanzania. from 1st April 2012 – 31st December 2012.
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Date
2012
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Hubert Kairuki Memerial University
Abstract
Background: The World Health Organization has been advocating the use of Partograph
as a necessary tool in the management of labour and recommends its universal use during
labour. However, some health-care practitioners, especially in high-income countries,
have questioned its effectiveness.
Objective: The aim of this study was to assess Partogram filling practices and its
associated effect on labor Outcomes to Low risk Pregnant women.
Materials and Methods: This Cross sectional comparative study with a prospective
follow up of Labor and Delivery till twenty four hours post delivery was conducted from
April to December 2012 to women who delivered at Amana Municipal Hospital, Ilala
district, Dar-es-salaam. The Partographs from attached Case Notes and Antenatal Cards
were retrieved and reviewed for the necessary information including partogram filling
components and the labor outcomes (Maternal and Fetal outcomes). A total of 1249
Patients were recruited in the study and only 702 Patients/Partographs were available for
analysis. The rest were lost to follow up, some left before twenty four hours and others
had misplaced Partographs.
Results: A total of 661 (94.2%) Partographs were incompletely filled. In this study it
was revealed that all participants with Bad Maternal Outcomes had incomplete Partograph
and result was significant at (p<0.05). This was not true for fetal outcomes which showed
no statistical significance. Assessment of Contractions once every four hours intervals
423(60.3%) and taking blood pressure at least once every hour 658(93.7%) were the
most Partograph components which were not done. Ninety four percent (94%) with
Perineal tears and eighty nine (89%) with Postpartum hemorrhage; the contractions
component was not assessed as needed for at least once in 4 hours intervals (p<0.0001).
The results also showed that out of 702 Participants, 89(12.7%) crossed the Action Line
before delivery. The main clinical decision made after crossing the Action Line was
Augmentation 60 (64%) and Caesarean Section 21 (23.6/o).
Conclusions and Recommendations: The study revealed that Partograph tool was
not properly filled and therefore the outcome of that Malpractice was associated with Bad
maternal outcomes though didn't show significant association with fetal outcomes in Low
risk Pregnant Women. Despite the above findings the health-care practitioners should not
be discouraged from the utilization of the Partograph to reduce poor Maternal outcome
and Fetal Outcome as well.
Description
A dissertation to be submitted in partial fulfillment of the requirements for the degree of master of medicine in obstetrics and gynaecology of the hubert kairuki memorial university.
Keywords
Labour, Pregnant women, Amana hospital
Citation
Bakengesa, V. K., 2012. Assessment of partogram filling practices and its associated effect on labour outcome to low-risk pregnant women delivering at Amana hospital, ilala Municipality, Dar es salaam, Tanzania. from 1st April 2012 – 31st December 2012. HKMU