Authors: Abdel-Badea A M, Ezzat N A, Mahmmoud M G
Early detection of prolonged labor is important, as postpartum hemorrhage, infection, birth tract injuries and childbirth-related death are common in women with prolonged labor, especially in primigravida women where protracted labor is more common. The risk of experiencing one or more of these complications is greater in countries with few resources, due to lack of early detection especially in rural areas where partogram is not explored. To assess the beneﬁts and adverse effects of using modified World Health Organization (WHO) partogram on primigravida women in active labor in a rural area, a clinical trial was carried out at Ad-dilinjat Central Hospital where the course of labor of 210 primigravida women with uncomplicated full-term pregnancies with a cephalic presentation in active labor was studied. Labor management according to the modified WHO partogram was compared to labor management without partogram. Compared to the non-partogram group, women in the partogram group had a short labor duration, a lower rate of caesarean section, and lower risk of needing a blood transfusion. However, they were at higher risk of perineal tears. Postpartum fever was more common in the non-partogram group (14.3%) than group A (8.6 %). A low APGAR score was observed more in non-partogram group (30.5%) compared to the partogram group (19%). No significant difference was seen in rates of NICU admission between the two groups. The use of partogram in a rural setting helps in the early detection of abnormal labor, guides timely intervention, and leads to the avoidance of prolonged labor and its sequelae, whereas application of partogram negatively affect rate of perineal tears.
primigravida, partogram, labor, cephalopelvic disproportion, postpartum hemorrhage
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