Partogram use may have some utility in low-resource settings. The present Cochrane review suggests use of a partogram as part of routine care is not associated with improvements in the rates of cesarean section, instrumental vaginal delivery or Apgar scores. For example, Walraven has suggested that use of the partogram can be an unnecessary interference in clinical work. However, some health-care practitioners, especially in high-income countries, have questioned its effectiveness. In such settings, the partogram serves a simple and inexpensive tool to monitor labor in a cost-effective way. Owing to resource constraints in such settings, it is usually not possible to monitor each woman continuously throughout the duration of labor. In under-resourced settings, prolonged labor and delay in decision-making are important causes of adverse obstetric outcomes. WHO advocates its use as a necessary tool in the management of labor and recommends its universal use during labor. The partogram has been heralded as one of the most important advances in modern obstetric care. Use of Partogram in Different Resource Settings In this context, we aim to decipher the efficacy and the utility of the partograph in the contemporary conduct of childbirth across all resource settings and health-care personnel and to suggest solutions to further enhance its efficacy in the optimizing labor outcomes. The partograph is an “easy-to-use” tool, but if not used correctly it will affect the final outcome.
However, some of the trials studied in this Cochrane review have limitations with respect to the settings, population studied and conduct of labor. Moreover, evidence of efficacy of partograph is equivocal as suggested by a Cochrane review. The function of the partograph is to monitor the progress of labor and identify and intervene in cases of abnormal labor.Įven though the partograph has been utilized for over four decades in obstetric practice, reports of obstructed labor and its serious maternal and fetal sequelae have questioned the efficacy of the partograph at times. It has recommended by the World Health Organization (WHO) for use in active labor.
The partograph or partogram has been established as the “gold standard” labor monitoring tool universally.
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