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Effect of partogram use on outcomes for women in spontaneous labour at term

Lavender T, Hart A, Smyth RMD
Published Online: 
10 July 2013

A partogram is usually a pre-printed form, the aim of which is to provide a pictorial overview of labour progress and to alert health professionals to any problems with the mother or baby. It has been unclear whether a partogram should be used and, if so, which design of partogram is better for women and babies. The review authors identified six randomised controlled trials involving 7706 women in spontaneous labour at term. Two studies, with 1590 women, assessed introducing the use of a partogram versus routine care without a partogram. Four studies, involving 6116 women, compared different types of partograms. Overall, there was no evidence from this review that using a partogram reduced or increased caesarean section rates or had any effect on other aspects of care in labour. Where different types of partogram were compared, no design appeared better than others. A single centre study, conducted in India, however, comparing a partogram with a latent phase (composite) and one without, demonstrated more favourable outcomes for the mother and baby when the modified chart was used. It is possible that partograms may be useful in settings with poorer access to healthcare resources, as studies in Mexico and Africa also showed some reduction in caesarean section rates with partogram use and early intervention for delayed progress in labour.