Comparing compliance with commencement and use of two partograph designs for women in active labour: A randomised controlled trial

Article


Lee, Nigel, Flynn, Julie, Gao, Yu and Kildea, Sue. 2023. "Comparing compliance with commencement and use of two partograph designs for women in active labour: A randomised controlled trial." Women and Birth. 36 (1), pp. e17-e24. https://doi.org/10.1016/j.wombi.2022.04.004
Article Title

Comparing compliance with commencement and use of two partograph designs for women in active labour: A randomised controlled trial

ERA Journal ID30465
Article CategoryArticle
AuthorsLee, Nigel (Author), Flynn, Julie (Author), Gao, Yu (Author) and Kildea, Sue (Author)
Journal TitleWomen and Birth
Journal Citation36 (1), pp. e17-e24
Number of Pages8
Year2023
PublisherElsevier
Place of PublicationNetherlands
ISSN1871-5192
1878-1799
Digital Object Identifier (DOI)https://doi.org/10.1016/j.wombi.2022.04.004
Web Address (URL)https://www.sciencedirect.com/science/article/pii/S1871519222000531
Abstract

Background: Documentation and assessment of progress in labour using a partograph is recommended by the World Health Organisation to assist in the timely recognition of labour dystocia. Recent studies have tested new designs of partographs that aim to account for more variable rates of labour progress. However, other studies have suggested that poor compliance in the completion of partographs affects utility. The objective of this study was to compare two types of partographs for compliance in documentation and use for managing labour. Methods: Low-risk nulliparous women in spontaneous labour (n = 228) were randomised to either an Action Line (control) (n = 114) or Dystocia Line partograph (intervention) (n = 114). Primary outcome was compliance with instructions for commencement of the partograph following a multifaceted training strategy. Secondary outcomes included compliance with the accompanying clinical management protocol for each partograph; and labour and birth outcomes. Results: The compliance rate for commencing the Action line partograph was 43.2% compared to 67.0% (p = 0.02) for the Dystocia line partograph. Other than a reduction in artificial rupture of membranes in the Dystocia Line group there were no other differences in labour management or birth outcomes. The use of centralised electronic display of labour progress may be a contributing factor. Conclusions: Compliance with the commencement and use of either partograph was low. There was little indication that the partograph was being utilized in the assessment and management of prolonged labour. Further studies are needed to explore the current utility of partographs in labour management and the effect of centralised monitoring of progress in high resource settings.

KeywordsActive labour management; Labour dystocia; Partogram; Partograph; Prolonged labour
ANZSRC Field of Research 2020420401. Clinical midwifery
420499. Midwifery not elsewhere classified
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Byline AffiliationsUniversity of Queensland
School of Nursing and Midwifery
Charles Darwin University
Institution of OriginUniversity of Southern Queensland
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