Evaluation of paperless partogram as a bedside tool in the management of labor

The partogram has been heralded as one of the most important advances in modern obstetric care. However, some healthcare practitioners, especially in high-income countries, have questioned its effectiveness. The purpose of this study is to evaluate prospectively the use of a paperless partogram as a bedside tool in the management of labor.

Women were invited to participate in the trial if they were at 36 to 42 weeks of gestation, and carrying a singleton pregnancy, with a cephalic presentation. All women who met the criteria and gave informed consent were included in the study till the required sample size of 91 was obtained. Progress of labor was monitored on the basis of Alert estimated time of delivery (ETD) and Action ETD. At the time of the Action ETD, if woman had not yet delivered, a diagnosis of abnormal labor was made and arrangements were made for emergency obstetric care.

Out of 91 women who participated in the study 55 (60%) were primigravida and 36 (40%) were multipara. The mean age of the participants was 25.36 years and the mean duration gestation was 281.9 days. The mean duration for delivery after Alert ETD was 4.3 hours. In our study, out of 91 participants, labor was induced only in 13% of the cases. The mean duration for delivery after Alert ETD was 4.7 ± 1.9 hours in the primigravida and 3.7 ± 1.8 hours in multipara, but these differences were not statistically significant.

In our study, the paperless partogram was found to be convenient and effective in the management of labor. The mean duration for delivery after Alert ETD was 4.3 hours in our study, which was similar to the World Health Organization's (WHO) recommendation for partograms, with a four-hour action line, denoting the timing of intervention for prolonged labor.