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A clinical study on the utility of alert and action line on partogram in management of labor in primigravidae and its impact

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Original Article

Author Details : Deepika Verma, Surabhi Gupta*

Volume : 7, Issue : 3, Year : 2020

Article Page : 379-386

https://doi.org/10.18231/j.ijogr.2020.081

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Abstract

Background: A good maternal and fetal outcome is of utmost importance for any obstetrician and
‘partogram’ is a very simple and important tool for such assessment.
Objective: To analyse the patterns of labor amongst spontaneous parturient using a WHO modified
partogram and to compare outcome of labor and neonatal outcomes in relation to partogram findings.
Materials and Methods: This prospective study was carried over a period of 18 months on 100 parturients.
Modified WHO Partogram was used to assess the progress of the labor. Parturients were divided on basis of
partogram findings. Group-I (n=64), where parturients partogram remained to the left of alert line, Group-
II (n=20), where parturients partogram remained between the alert and action lines and Group-III (n=16),
where parturients partogram crossed the action line. In these three groups, the maternal and fetal outcomes
were assessed.
Results: Normal vaginal delivery was done in 95.3% of Group-I, 80% of Group-II and 43.75% of Group-III
parturients. Instrumental delivery was done in 1.56% of Group-I, 10% of Group-II and 18.75% of Group-
III parturients. LSCS was done in 3.1% of Group-I, 10% of Group-II and 37.5% of Group-III parturients.
Instrumental / LSCS deliveries were higher in Group-II and Group-III parturients. A large proportion of
newborns of Group-II and Group-III parturients had Apgar Score <7> Conclusions: The Modified WHO partogram is very helpful in the prediction of maternal and fetal
outcome. It is highly recommended for use in resource deficient medical facilities, where early decision
for delivery or referral can be taken on the basis of partogram findings.

Keywords: Primigravida, Partogram, labor, Alert line, Action line, Modified WHO partogram.

How to cite : Verma D , Gupta S, A clinical study on the utility of alert and action line on partogram in management of labor in primigravidae and its impact. Indian J Obstet Gynecol Res 2020;7(3):379-386

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