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Partogram use in the Dar es Salaam perinatal care study
A S Nyamtema1, D P Urassa, S Massawe
1Tanzanian Training Centre for International Health, Ifakara, Tanzania. angelo.nyamtema@healthtrainingifakara.org
Objective:
To assess the quality of partograms used to monitor labor in Dar es Salaam hospitals, Tanzania.
Methods:
The study team reviewed the records of the parameters of labor, and maternal and fetal conditions in 367 partograms, and interviewed 20 midwives.
Results:
All midwives interviewed had been previously trained to use the partogram. Of all partograms reviewed, 50% had no records of duration of labor. Although cervical dilation and fetal heart rates were recorded in 97% and 94% of the partograms respectively, 63% and 91% of these were judged to be substandard. Substandard monitoring of fetal heart rates was strongly associated with poor fetal outcome (P<0.001). Blood pressure, temperature, and pulse rates were not recorded in 47%-76% of partograms.
Conclusion:
These findings reflect poor management of labor and indicate urgent in-service training to address the importance of documentation and regular partogram audit in order to reduce maternal and perinatal deaths.
