Clinical Audit on Effective Usage of Partogramin Obstetric Unit B of DGHKalutharafrom 01stof March to 31st of May 2016

Abstract

WHO recommend partogram for universal use during labour as a necessary tool. Continuous monitoring during labour provides a safe care. Further it prevents adverse outcomes relating to child birth. The tool helps to identify deviations early and intervene timely. Annually a huge sum of money is spent on maternal health by the government of Sri Lanka to deliver a free health care to the public. The maternal mortality reported to be low despite Sri Lanka been a developing country. Hence, it is the duty and responsibility to keep the statistics further low and maintain excellent quality of care with the available resources. Since partogram can detect obstructed labour early, it helps to reduce maternal deaths by preventing uterine rupture, post partumhaemorrhage and puperial infections. Perinatal mortality reduces when traumatic deliveries are less. It is appreciate the use of the tool as it is simple, inexpensive and freely available. The goal of this audit is to assess the effective use of partogram in the local setting. A descriptivestudy was conducted in obstetric unit B of DGH-Kalutara. The total of 571 of deliveries in March, April and May 2016 were selected for the audit. Effective usage of partogram was assessed by executing partograms of relevant BHTs. Data collection and analysis was done by the auditor. Client information is included in majority of partograms. Position, caput, moulding, cervical dilatation, contraction free interval, duration of contraction and abdominally descent were not marked in the majority and the technical errors noted during marking. Practical issues in monitoring and documenting of contraction free interval and duration of contraction should be addressed. Maternal monitoring and second stage foetal monitoring should be encouraged. A proper training programme of National Partogram should be arranged.