Abstract

World Health Organization (WHO) recommends partogram for universal use during labour as a necessary tool. Continuous monitoring during labour provides a safe care. Further it prevents adverse outcomes relating to child birth. The tool helps to identify early deviations and intervene timely. Annually, a huge sum of money is spent on maternal health by the government of Sri Lanka to deliver a free health care to the public. The maternal mortality is reported to be low despite that Sri Lanka is a developing country. Hence, it is the duty and responsibility to keep the statistics further low and maintain excellent quality of care with the available resources.

Since partogram can detect obstructive labour early, it helps to reduce maternal deaths by preventing uterine rupture, postpartum haemorrhage and puerperal infections. Perinatal mortality is reduced when traumatic deliveries are less.  It appreciates the use of the tool as it is simple, inexpensive and freely available. The goal of this audit is to assess the effective use of partogram in the local setting.

A descriptive study was conducted in obstetric unit B of District General Hospital(DGH)-Kalutara. A total of 571 of deliveries from March to May in 2016 were selected for the audit. Effective use of partogram was assessed by executing partograms of relevant BHTs. Data collection and analysis was done by the auditor.

Client information is included in majority of partograms. Position, caput, moulding, cervical dilatation, contraction free interval, duration of contraction and abdominal descent were not marked in the majority and the technical errors were noted during marking.

Practical issues in monitoring and documenting of contraction free interval and duration of contraction should be addressed. Maternal monitoring and second stage foetal monitoring should be encouraged. A proper training programme of National Partogram should be arranged.