A partogram or partograph is a composite graphical record of key data (maternal and fetal) during labour entered against time on a single sheet of paper. Relevant measurements might include statistics such as cervical dilation, fetal heart rate, duration of labour and vital signs. In, 1954 Friedman prepared the cervicography. In 1972 Philpott and Castle, working in Rhodesia (now Zimbabwe), developed the first partograph, by utilizing Friedman's cervicograph, and adding the relationship of the presenting part to the maternal pelvis. It is intended to provide an accurate record of the progress in labour, so that any delay or deviation from normal may be detected quickly and treated accordingly. However, a Cochrane review came to the conclusion that there is insufficient evidence to recommend partographs in standard labour management and care.

Components

Advantages

Limitations

Usage

A partograph is contained in the Perinatal Institute's "Birth notes". Use of a partograph in established labour is recommended by the National Institute for Clinical Excellence (NICE) in the "Intrapartum Care" guideline.

Digital partograph

A digital partograph is an electronic implementation of the standard paper-based partograph/partogram that can work on a mobile or tablet PC. Partograph is a paper-based tool developed by the W.H.O. to monitor labour during pregnancy. The use of the partograph is recommended as an important indicator for monitoring intrapartum care. Partograph includes several labour vitals including cervix dilatation of the mother. Plotting the cervix dilatation against time can help in predicting deviation from the normal progress of labour. In order to overcome the limitations of paper-based partograph, various researchers have suggested the use of digital partograph. Much literature is available regarding the feasibility of a digital partograph.

Advantages

Mitigating human errors

According to standard W.H.O. protocol different labour vitals needs to monitor at a different interval based on the stage of pregnancy. Electronic partograph can remind the staff nurse to enter labour vital in case they forget the standard protocol. In some cases, such small aid can be life-saving by decreasing the delay in decision making.

Increased accountability & preventing false data entry

Very often the partograph is filled after the delivery only for the record keeping purpose. With electronic records, it is impossible to temper the data. Actual time of data entry can be logged easily. This allows obtaining a correct metric of protocol adherence for the labour monitoring process.

Allows easy data analysis

Data is essential in healthcare. One side effect of electronic partograph is that it makes a digital copy of the data available. Partograph itself is a very basic form of AI. But with more data, we can improve the underlying algorithm to predict the complications. It is possible to use nonlinear, multidimensional mathematical models for predicting adverse outcome during pregnancy with such data.

Availability

Another common reason for low partograph usage is its availability. This problem can be solved by using a digital medium provided an adequate power supply is available for the new device.

Ease of use?

Plotting paper partograph requires training. Digital photographs can be made highly simple to use by taking advantage of recent advances in human-computer interaction. However, the perceived ease of use is highly subjective. Non-tech savvy users might find such shift overwhelming. It is important to pick the correct solution in order to make sure that it is seen as easy to use by its end users.