An Analysis Of Characteristics Of Labour And Outcome Before And After The Introduction Of The Partograph In A Hospital In Ghana.

Abstract

The main purpose o f th is retrospective comparative stu dy o f randomly selected women was to assess the partograph as an aid to parturition and to p ro v id e fu r th e r information to s u p p o rt more widespread use o f this instrument and id e n tify any areas where improvement could be made. Two groups o f women expecting their first babies were s tudie d. The p re -partograph group comprised 65 women who delivered in 1988 before the partogrph programme was introduced in Ghana. The post-partograph group composed o f 76 women who had th e ir babies in 1991, two years a fte r the inception o f th e programme. There was a statistically significant difference between the two groups which showed that more women in the postp a rto g ra p h group were given sedatives and tranquillisers in llabour (P<0.01). There appeared to be trends showing a decreased incidence o f delivery by caesarean section, an increase in the event o f pos t-partum haemorrhage and a decrease in the post-natal antibiotic requirement in the post-partograph gropu , although , statistically significant differences were not reached. The discrepancies between the two groups were not statistcally significant for any other of the parameters tested. The findings endorsed the value o f the partograph as a simple, low-cost and efficient tool as an aid to confinement. However, questions are raised about th e use of the admission time as the basis fo r the calculation of the duration of labour, since the short duration so estimated is not a representation o f the woman’ s own experience of labour. The admission time approach suggested by Hendricks et al (1970) under estimates the mothers d iagnosis/experience o f labour, [Wilcoxon matched-pairs signed rank te s t, P< 0.05.] By contrast, th e cervical dilatation time-scale approach o f calculation does provide a more similar value to the mother’s estimation/experience, [Wilcoxon matched-pairs signed rank test; P<0.01,] than th a t o f Hendricks et al (1970).