The Relationship between the Use of the Partograph and Birth Outcomes at Korle-Bu Teaching Hospital

Abstract

The purpose of this study was to examine the relationship between the use of the partograph and maternal interventions as well as maternal and neonatal outcomes. A retrospective chart review of 1,845 primiparous and multiparous deliveries which met the inclusion criteria was conducted. Using pre-established criteria only 472 (25.6%) charts were adequately completed and on inspection some of these appeared to be completed retrospectively. Whether or not timely action was taken if the “action line” was crossed on the partograph was also assessed. Chi-square analysis showed that when the partograph was adequately used, there were more interventions to augment labour. There were differences in maternal outcomes with women being less likely to lose more than 500 millilitres of blood if partographs were adequately used. Although there were 13 intra partum deaths only one chart could be retrieved. While there appeared to be less pyrexia with the group whose partograph was inadequate, it is possible that this group also had their temperature monitored less frequently. Decreases in newborn outcomes including Apgar scores, birth injuries, NICU admissions and mortality were not found. Recommendations were made to facilitate accurate documentation and completion of the partograph to help in taking prompt decisions or interventions. Periodic in-service training for record officers in health facilities is recommended to improve filing system to ensure easy retrieval of patients charts. Recommendations to shorten the length of time that action is taken when the action line was crossed.