The Completion Rate Of Modified World Health Organization-Partograph And Its Association With Maternal And Perinatal Outcomes In Jimma Specialized Hospital, Oromia, Ethiopia.

Abstract

Introduction :- The management of labor using partograph is the standard way of improving both maternal and perinatal outcome. It increases the quality and regularity of all observations on fetus and the mother during labor and aids in timely recognition of problems in both mother and fetus. [1-3] Objectives:-The objective of this study was to assess the completion rate of partograph recordings and its association with maternal and perinatal outcomes among women delivering in Jimma University Specialized Hospital (JUSH). Method:--A facility-based prospective descriptive cross-sectional study was conducted in JUSH from June- 01/2014 –August-30 /2014. In this study all women who were delivered in JUSH were included and labor was monitored using modified WHO-partograph. Recordings of parameters of labor in partograph, fetal outcomes (APGAR-score, NICU-admissions, still birth) and immediate maternal outcomes (PPH, Tear, visceral injury….) were assessed using check lists .The data were collected through face to face interview and observations of the partograph recordings and analyzed by SPSS-window -20. Bivariate and Multivariate Logistic regression was used. Variables having P<0.25 from bivariate analysis was included in multivariable logistic regression analysis. Finally, statistical significance was declared at P<0.05. Result:-Total of 318 partographs were reviewed using prepared checklist. Of the total partograph reviewed only 20.4% of partograph had all parameters with standard recording. The most unrecorded parameters were fetal skull molding-76.1% and most recorded uterine contraction and cervical dilatation 93.7%. Substandard Fetal heart rate, Recording of liquor status and Measurement of maternal body temperature-monitoring have a significant association with adverse fetal (still birth, NICUadmission, Low APGAR-score at 5th-minute and Early neonatal death) perinatal and adverse maternal (Postpartum hemorrhage, Sepsis, Chorioamnionitis. Tear, Death...) Outcomes. Conclusion and Recommendation: - This study found high proportion of substandard partogram recordings. Substandard recordings of fetal heart rate, maternal body temperature, and liquor status were significantly associated with adverse fetal and maternal outcomes. Wide scale study should be undertaken using this as base line .Supervisory mechanisms and on job training on partograph use are important to improve labor monitoring and standard recording