Department of Nursing, Faculty of Medical and Health Sciences, Samara University, Samara, Ethiopia.
Reprod Health. 2013 Apr 18;10:23. doi: 10.1186/1742-4755-10-23.
The World Health Organization (WHO) recommends using the partograph to follow labour and delivery, with the objective to improve health care and reduce maternal and foetal morbidity and death. The partograph consists of a graphic representation of labour and is an excellent visual resource to analyze cervix, uterine contraction and foetal presentation in relation to time. However, poor utilization of the partograph was found in the public health institutions which reflect poor monitoring of mothers in labour and/or poor pregnancy outcome.
A retrospective document review was undertaken to assess the completion of the modified WHO partograph during labour in public health institutions of Addis Ababa, Ethiopia. A total of 420 of the modified WHO partographs used to monitor mothers in labour from five public health institutions that provide maternity care were reviewed. A structured checklist was used to gather the required data. The collected data were analyzed using SPSS version 16.0. Frequency distributions, cross-tabulations and a graph were used to describe the results of the study.
All facilities were using the modified WHO partograph. The correct completion of the partograph was very low. From 420 partographs reviewed across all the five health facilities, foetal heart rate was recorded into the recommended standard in 129(30.7%) of the partographs, while 138 (32.9%) of cervical dilatation and 87 (20.70%) of uterine contractions were recorded to the recommended standard. The study did not document descent of the presenting part in 353 (84%). Moulding in 364 (86.7%) of the partographs reviewed was not recorded. Documentation of state of the liquor was 113(26.9%), while the maternal blood pressure was recorded to standard only in 78(18.6%) of the partographs reviewed.
This study showed a poor completion of the modified WHO partographs during labour in public health institutions of Addis Ababa, Ethiopia. The findings may reflect poor management of labour or simply inappropriate completion of the instrument and indicate the need for pre-service and periodic on-job training of health workers on the proper completion of the partograph. Regular supportive supervision, provision of guidelines and mandatory health facility policy are also needed in support of a collaborative effort to reduce maternal and perinatal deaths.
世界卫生组织（WHO）建议使用产程图来监测分娩过程，目的是改善医疗保健并降低母婴发病率和死亡率。产程图是分娩的图形表示，是分析宫颈、子宫收缩和胎儿位置与时间关系的极好的可视化资源。然而，在公共卫生机构中发现产程图的使用情况不佳，这反映了对产妇分娩的监测不佳和/或妊娠结局不佳。
我们进行了一项回顾性文件审查，以评估在埃塞俄比亚亚的斯亚贝巴的公共卫生机构中使用改良的 WHO 产程图来监测产妇分娩的情况。我们共审查了来自提供产科护理的五家公共卫生机构的 420 份用于监测产妇分娩的改良 WHO 产程图。我们使用结构化检查表收集所需数据。使用 SPSS 版本 16.0 分析收集的数据。我们使用频率分布、交叉表和图表来描述研究结果。
所有设施都在使用改良的 WHO 产程图。正确填写产程图的情况非常低。在来自五个卫生机构的 420 份产程图中，有 129 份（30.7%）记录了胎儿心率，有 138 份（32.9%）记录了宫颈扩张，有 87 份（20.70%）记录了子宫收缩符合推荐标准。该研究没有记录 353 份（84%）产程图中胎先露的下降情况。在审查的 364 份（86.7%）产程图中没有记录胎头塑形情况。有 113 份（26.9%）记录了羊水状态，只有 78 份（18.6%）记录了产妇血压符合标准。
这项研究表明，在埃塞俄比亚亚的斯亚贝巴的公共卫生机构中，改良的 WHO 产程图在分娩过程中的填写情况不佳。调查结果可能反映了对分娩的管理不善，或者仅仅是仪器填写不当，并表明需要对卫生工作者进行入职前和定期在职培训，以正确填写产程图。还需要定期提供支持性监督、提供指导方针和强制性医疗机构政策，以支持减少母婴和围产期死亡的合作努力。
