A Prospective Study on Partographic Observations in a Primigravida with Spontaneous Versus Induced Labour at a Tertiary Care Center
Keywords:Protogram, Labour, APGAR, Primigravida, WHO, Pelvis
Background:Labour depends on uterine contractions, cervical dilatation and effacement. It also depends on pelvis and fetal weight. Once labour has started it is possible to regulate its duration and progress. This requires careful diagnosis of onset of labour, regular assessment and decisive action.Aim & Objective: The aim of present study is to compare the labour progress and delivery outcome among induced versus spontaneous labour in women at term using simplified WHO partogram.Methodology: This study was conducted at Government Medical College & Hospital, Nalgonda over a period of 12 months from September 2019 to August 2020. It is a prospective study conducted on 200 antenatal women. 200 women were primigravida, routine history ,physical examination, systemic, obstetric examination and routine investigation and ultrasound scan done. Results: Out of 200 primigravida 100 were allowed for spontaneous labour and another 100 labour was induced with prostaglandins. Partogram was plotted when women reached 4cm dilatation and all partographic observations noted. The labour progress and delivery outcome was measured by total duration of labour, caesarean section rate, comparison of deliveries in group A,B,C ,mean birth weight and APGAR score. Mean total duration in induced group is 3.1hr,in spontaneous is 3hrs,caesarean section rate was high in induced group. Incidence of caesarean section is high in group C (which crossed action line).Most common indication for caesrean section was cephalo pelvic disproportion and fetal distress. Most women delivered before the alert line(groupA) in both induced and spontaneous group. Mean APGAR at 1min and 5min was similar in both groups. APGAR was low in both groups who crossed action line .Incidence of tachysystole is high in induced group compared to spontaneous group 15% cases in induced labour had APGAR 5-6 whereas 3% in spontaneous has 5-6 Incidence of MSL is 16% in induced labour when compared to 9% in spontaneous labour Induced labour is comparable to spontaneous labour when it is partographically monitored. Conclusion:Partogram is efficient, time saving and gives a clear picture of labour. It facilitates anticipation with reasonable certainty of labour problems and indicates the need for clinical re-evaluation.
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Copyright (c) 2021 Vijayasree J, Kavitha Bhalki, P. Padma
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