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Assessing Partograph Recordings and Perinatal Outcomes at Queen Elizabeth Central Hospital Malawi
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Dissertation
Assessing Partograph Recordings and Perinatal Outcomes at Queen Elizabeth Central Hospital Malawi
2016
Overview
The development of the partograph provides health professionals with a pictorial overview of labour progress, maternal and foetal condition and aids in early identification and management of complications such as poor progress of labour, prolonged labour, foetal distress, and, in the worst cases, obstructed labour and ruptured uterus. The aim of this study was to assess the documentation of the partograph recordings and perinatal outcomes during intrapartum period at Queen Elizabeth Central Hospital which is situated in the southern region of Malawi. A descriptive cross sectional study was conducted using a simple random sampling of 246 partographs. Using a checklist, recordings of observations on foetal, progress of labour and maternal parameters were assessed and given a grade as completely documented, adequately documented, inadequately documented and grossly inadequately documented.Results indicated that only 1.2% of the partographs were completely documented with observations on foetal, maternal and labour progress. Foetal heart rate monitoring was documented according to standard in only 2.4% of partographs and not recorded at all in 11.8% of the partographs. There was no association between recordings of foetal parameters (foetal heart rate, status of membranes and degree of moulding) and neonatal birth outcome (p = 0.713). The reviewed records showed 4 fresh still births and 21 newborns who were admitted to neonatal intensive care unit with Apgar score of less than 7 at 5 minutes within a period of one month. On labour progress, cervical dilatation was the only parameter that was more documented according to standard in 33.7% (n = 83) of the partographs as compared to the documentation of uterine contractions which was 4.5% (n = 11) and of descent of presenting part which was 5.9% (n = 14) of the partographs. On maternal parameters, blood pressure was not documented in 65.4% of the partographs reviewed and respirations were documented in only 3.3% of the partographs. On the maternal condition, the findings did not show a significant association between partograph recordings and immediate maternal outcomes. Though not statistically significant but very important, women experienced adverse outcomes such as pre-eclampsia (n = 4), uterine tears (n = 4) and postpartum haemorrhage (n = 13) were experienced by the women.There is need to investigate on possible explanations as to why the partographs were not documented according to World Health Organization's recommended guidelines.
Publisher
ProQuest Dissertations & Theses
Subject
ISBN
9798384060376
