Published: 2018-03-27

Comparison of normal and abnormal labour by using Modified WHO Partograph

Manojkumar J. Bhatt, Gunvant K. Kadikar, Medha Kanani, Shivani Shah


Background: Modified WHO partograph is graphical record of maternal and foetal data during progress of labour entered against time on single paper sheet. Entire labour can be interpreted in a glance on the photograph. It helps to detect abnormal progress of labour. It guides obstetrician to decide about the need for augmentation of labour or termination of pregnancy either by instrumental delivery or LSCS and avoids prolong labour before obstruction. The objectives were to study the course of normal and abnormal labour and to evaluate the maternal and perinatal outcome in normal and abnormal labour.

Methods: The prospective observational hospital based study of 200 randomly selected cases coming to sir t hospital, bhavnagar for delivery during September 2016 to August 2017 was done. Progress of labour assessed by use of modified WHO partograph. Various parameters like duration of labour, mode of delivery, maternal and neonatal morbidity were studied.

Results: The average duration of active first stage of labour was 4 hrs 38 mins in normal labour and 7hrs 48 mins in abnormal labour. Arrest of descent was responsible for 40% of abnormal labour. Problems like obstructed labour were avoided by timely intervention in the form of cesarean section and instrumental delivery. Maternal and perinatal outcome were satisfactory.

Conclusions: Routine use of modified WHO partograph helps in early detection of abnormal course in labour. Every women in labour must be benefitted by use of modified WHO partograph for labour monitoring. It assures best maternal and perinatal outcome.


Modified WHO partograph, Maternal morbidity, Perinatal morbidity

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Maternal Mortality Rates. A Tabulation of Available Information, WHO document FHE/86-3, 2nd Ed, 1996.

Friedman E. The graphical analysis of labour. Am J Obset Gynecol. 1954:68:1568-75.

Philpott RH, Castle WM. Cervicographs in the management of labour in Primigravidae. Int J Gynecol Obstet. 1972 July;79(7):592-8.

WHO partograph cuts complications of labor and childbirth. Safe Mother. 1994;(15):10.

Mathews JE, Rajaratnam A, George A, Mathai M. Comparison of two World Health Organization (WHO) partographs. Int J Gynecol Obstet. 2007 Feb;96(2):147-150.

Hendricks, CH, Brenner, WE, Kraus, G. Normal cervical dilatation pattern in late pregnancy and labour. Am J Obstet Gynecol. 1970; 106(8):1065-82.

Studd J. Partograms and Nomograms of Cervical Dilatation in Management of Primigravid Labour. BMJ. 1973 Nov;4(5890):451-5.

Drouin B, Nasah BT, Nkounawa F. The value of the partogram in the management of labour. Qbstet Gynaecol. 1979;53(6):741-5.

Vaidya PR, Patkar LV. Monitoring of labour by partogram. J Obstet Gnnecol. 1985:41(3)

Shrotri AN. Early recognition of abnormal labour in primi gravidae. J Obset Gynecol India. 1991:41(3).

Sizer AR, Evans J, Bailey SM, Wiener J. A second-stage partogram. Obstet Gynecol. 2000;96(5):678-83.

Dangal G. Preventing prolonged labor by using partogram. Int J Gynecol Obstet. 2007;7(1).

Orji EO, Fatusi AA, Makinde NO, Adeyemi AB, Onwudiegwu U. Impact of training on the use of partograph on maternal and perinatal outcome in peripheral health centers. J Turkish-German Gynecol Assoc. 2007;8(2):344-7.

Iffat J, Shereen B, Tabassum S. Role of partogram in preventing prolonged labor. J Pakistan Med Assoc. 2007 Aug;57(8):408-11.

Windrim R, Seaward PG, Hodnett E, Akoury H. A randomized controlled trial of a bedside partogram in the active management of primiparous labour. J Gynecol Obstet Canada. 2007 Jan; 29(1):27-34.

Lavender T, Hart A, Smyth RM. Effect of partogram use on outcomes for women in spontaneous labor at term. Cochrane database system rev 2008 Oct;60(4):CD005461.

Meena R, Gangwal M, Agarwal S, Bairwa R, Meena M, Meena A. Outcome of labour monitored by W.H.O. modified partograph and latent phase partograph. BMR Med. 2016;3(1):1-7

Khan KS, Rizvi A. The partograph in the management of labor following Cesarean section. Int J Gynecol Obstet. 1995;50(2):151-7.

Wayne R, Friedman, Emanuel A. Labor: clinical evaluation and management. New York, Appleton-Century Crofts;1978:2.

Shinde KJ, Bangal V, Singh RK. study of course of labour by modified WHO partograph. IJBAR. 2012;03:05.