partograph

Partograph (also called partogram) is a graphical tool used in obstetrics to monitor the progress of labor and the condition of the mother and fetus. By recording key parameters in real time, it helps clinicians identify labour dystocia and decide when to intervene.

The standard chart plots time on the horizontal axis and cervical dilation in centimeters on the vertical axis; optional graphs record fetal heart rate, uterine contractions, descent of the presenting part, amniotic membrane status, and maternal vital signs such as blood pressure, pulse, and temperature. The alert line typically represents a normal rate of dilation (for example 1 cm per hour in active labor) and the action line is drawn to indicate when more rapid progress or intervention may be warranted.

History and use: Partographs originated from work in the mid-20th century and were further developed and promoted by international bodies such as the World Health Organization. They have been widely adopted in many settings to provide a standardized record of labor progress and maternal–fetal status, particularly in intrapartum care.

Effectiveness and limitations: Evidence on the impact of partographs is mixed. Some systematic reviews report modest reductions in prolonged labor and cesarean rates, while others find little or no additional benefit. Benefits depend on proper training, adherence, and charting quality; limitations include subjectivity, variability in definitions of labor progress, and the potential for over-interpretation.

Today, many hospitals use paper-based or electronic partographs, sometimes integrated into broader electronic medical records. The tool remains a common component of obstetric monitoring, especially in settings where timely decision-making is essential.