Division of Reproductive Health

Division of Reproductive Health

Partograph Case Studies

DRH/ MOH

Division of Reproductive Health

 Emergency Obstetric Newborn Care Harmonised Training

Symbols Usual frequency of examination

Cervix x
Vaginal examination 4 hourly
Head O
Breech w Fetal Heart Rate ½ - ¼ hourly

Foetal heart rate

Contractions: Palpate abdomen (uterine fundus) over
10 min.
Amniotic fluid
Mild < 20 seconds
Membranes intact I
Moderate 20-40 seconds
Membranes ruptures, clear fluid C
Strong > 40 seconds
Meconium stained fluid MS
Blood stained fluid BS
Descent: Abdominal palpation1
Moulding
Sutures apposed +
Sutures overlapped but reducible 2+

Sutures overlapped but not 3+

reducible
Division of Reproductive
4 and childbirth
1. WHO Managing complications in pregnancy Health
 Emergency Obstetric Newborn Care Harmonised Training Partograph
Case 1

Name: Mrs KA
History
Hospital No.: 462432 XY
•Lower abdominal pains
Age (Years): 20 •No drainage of liquor
Parity: Para 0 + 0
Gestational age 38
(Weeks):
Contraction
Cervi Membranes/ FHR
Time Lie Presentation Moulding Descent s
x (cm) Liquor (/Min.)
(/10 Min.)
longitudin 2 (<20
9am 2cm Intact Cephalic 140 o 5/5
al seconds)

Time 9am
Questions Pulse rate (/Min.) 90
1. What actions will you take? Blood pressure
120/80
2. Will you offer pain relief? (mmHg)
3. What options for pain relief would you use? Temperature (o C) 37.1o

Division of Reproductive Health

 Emergency Obstetric Newborn Care Harmonised Training Partograph
Case 2
Name: Mrs AD
Hospital No.: 462432 XY History
•Lower abdominal pains for 2 hours
Age (Years): 25 •Drainage of liquor for 1 hour
Parity: Para 2+0
Gestational age (Weeks): 38

Tim Cervi Membranes/ Presentatio FHR Mouldin Descen Contractions

Lie
e x (cm) Liquor n (/Min.) g t (/10 Min.)
4pm 5cm Clear longitudinal Cephalic 144 0 3/5 3 (35sec. each)

8pm 9cm clear 146 + 2/5 4 (45 sec. each)

longitudinal Cephalic

Time 4pm 8pm

Questions
Pulse rate (/Min.) 88 90

Blood pressure
What actions will you take? (mmHg)
120/70 120/70

(at 4pm and at 8pm) Temperature (o C) 37o 37o

Division of Reproductive Health

 Partograph
Emergency Obstetric and Newborn care Training
case 3
Name: Mrs HA
Hospital No.: 462432 XY History
•Labour at home for 6 hours
Age (Years): 16 •Membrane ruptured 4 hours before admission
Parity: Para 0 + 0
Gestational age (Weeks): 39
Time Cervi Membranes/ Lie Presentatio FHR (/Min.) Moulding Descent Contractions
x Liquor n (/10 Min.)
(cm)
Spontaneous Cephalic
10am 5cm L 150 1+ 3/5 3 (30 sec. each)
rupture, clear

2pm 6cm Blood stained L Cephalic 156 2+ 3/5 4 (40 sec. each)

Meconium
4pm 6cm L 164 3 + 3/5 4 (45 sec. each)
stained Cephalic
Time 10am 2pm 4pm
Pulse rate (/Min.) 80 86 92
Blood pressure (mmHg)
120/70 130/70 130/70

Temperature (o C) 37 37.2 37.2

Questions
1. Plot the information on a partograph 2. When
Division of would youHealth
Reproductive perform the next vaginal examination?
3. What action will you take in a BEOC and CEOC health facility?
 Partograph
Emergency Obstetric and Newborn Care Training Case 4
Name: Mrs SA
Hospital No.: 462432 XY History

Age (Years): 24 •Lower abdominal pains 3 hours

•Drainage of liquor 2 hours
Parity: Para 3+1
Gestational age (Weeks): 39

Time Cx Membranes/ Lie Presentatio FHR (/Min.) Moulding Descent Contractions

(cm) Liquor n (/10 Min.)
10am 5cm Spontaneous Cephalic
rupture 2 hours L 140 0 3/5 3 (30 seconds)
ago, clear

2pm 10cm Clear L Cephalic 156 1+ 3/5 3 (40 seconds)

3pm 10cm Clear L Cephalic 120 2+ 1/5 3 (45 seconds)

Questions Time 10am 2pm 4pm

Pulse rate (/Min.) 86 90 92
1. You are called. What would you Blood pressure (mmHg) 130/70 130/70 130/70
do?
2. What are the options for delivery? Temperature (o C)
37o 37o 37

Division of Reproductive Health

Questions/ Comments

Division of Reproductive Health