FACULTY OF MEDICINE & HEALTH SCIENCES

OBSTETRIC & GYNAECOLOGY POSTING

MDP 30408
2010/2011

ABNORMAL PARTOGRAM

Student name : Muhamad Danial Bin Salim

Matric Number : 21593
Supervisor : Dr. Khine Myat Min
Coordinator : Dr. Saw Moo K’Baw
Introduction

Madam Mena Ak Empaian, 37 years old Iban, housewife. Gravida 4 Parity 3 at 39 weeks + 1 day period
of Amenorrhaea. She was transferred from antenatal ward to labour ward on 18 July 2010 at 0710.

Interpretation of partogram

1. Progress of labour
Upon admission to labour ward at 0710, Madam Mena was found to be in active phase of 1 st stage
of labour. This was proved by 4 cm of cervical dilatation and station was -1cm. The uterine
contratcion was 3 in 10 minutes with interval of 30 – 40 seconds

0810
Artificial rupture of membrane was done and clear liquor were noted. Cervical dilatiton at this point
was 6 cm and station at -1cm with uterine contraction was recorded 4 in 10 minutes with interval of
40 seconds.

0910
The cervical dilatation was still at 6cm and station at -1cm. The uterine contraction was also 4 in 10
minutes with above 40 seconds interval of contraction.

1010
Vaginal examnation reveals cervical dilatation increase to 7cm but station still remain -1cm. The
contraction was 4 in 10 with above 40 seconds interval.

1110
Cervical dilatation and station increase to 9cm and +1cm respectively, The uterine contraction also
increase to 5 in 10 minutes with interval of above 40 seconds

1210
The cervical dilatation and station remaind at 9cm and +1cm respectively. The contraction still 5 in
10 minutes with interval of above 40 seconds

1310
Cervical dilatation and station still same. 9cm and +1cm respectively. The uterine contraction was
good at the highers point that was 5 in 10 minutes with interval of above 40 seconds. Thus, the
labour go into prolonged 2nd stage. An asisted labour delivery was done( Ventose Delivery)

2. Fetal Well – being

The fetal monitpring was done along the progression of labour by the Cardiotopograph (CTG). The
fetal heart rate increase at the 1st one and a half hours but then showed decreasing patern till 1310
the fetal heart rate showed that the fetus was in bradycardia.
3. Matenal well – being
Madam Mena’s vital signs were normal except the blood pressure. A little bit higher that was
150/90mmHg. The pulse rate was fluctuated from 100 – 80 beats per minute. The temperature was
normal 37°C. 60ml urine collected at 0810. To reduce pain, phetidine 80mg was given intramuscular.

Conclusion

In a nutshell, this was definetely an abnormal partogram becouse the character shown second arest
start 1110. The cervical od not progress for 3 hours. The fetal head descent also did not showed any
progress, only stop at +1cm. The fetal heart rate was noted to be brady cardia at 1310. Despite that the
uterine contraction was good progress from 3 in 10 till 5 in 10 minutes with the interval on above 40
seconds. This condition mostlikely because of less effort from the mother. The indication for ventose
delivery are delay in second stage of labour, fetal distress and maternal condition required attention.
The complication of ventose delivery are trauma, adematous skin bump, cephal hematoma and serious
infaction at the head