Influence of parity on the partographic management of labour in a Nigerian tertiary hospital.

OBJECTIVE

To assess whether parity influences progress of labour between primigravidae and multiparae as recorded on the partgraph.

PATIENT AND METHODS

Retrospective analysis of partographs of women who were monitored with partograph prior to delivery. Participants were selected using specified exclusion criteria.

RESULTS

Out of the 1,319 deliveries in the year 2004, 445 women had partographic monitoring; 368 medical records were retrieved and analysed. There were 136 (37.0%) primigravidae and 232 (63.0%)multiparae. The two groups were similar in booking status and risk level. Primigravidae had lower rates of spontaneous labour onset (78.7%) and thus higher rates of induction labour (21.3%) than multiparae [p< 0.05; OR.51, 95% Cl (0.28 - 0.93). Primigravidae presented at lower cervical dilatations and had more frequent vaginal examination than multiparae. Most multiparae (78.2%) had delivered within 6 hours of admission compare with primigravidae (53.1%); prolonged labour occurred more frequently in primigravidae than multiparae (6.9% vs 1.8%). These differences were statistically significant (p=0.000). Higher rates of inadequate uterine contractions were noted among primigravidae. Primigravidae more frequently crossed the alert and reached the action lines compared with multiparae; higher rates of augmentation of labour and emergency caesarean section were also recorded among primigravidae. The outcomes for mother and infant were similar in the two groups.

CONCLUSION

Primigravidae are at a higher risk of dystocia compared with the multipara. Quality monitoring of the primigravida with the partograph will reduce the morbidity and mortality in both mother and the newborn.