A partogram is a sheet where care providers record information during the course of labor to monitor the progress of labor and identify causes of concern for the purpose of making appropriate interventions. In addition to being useful for the management of labor, it is also an important tool for protection from liability, as it offers detailed documentation about the labor and who was present in the event of a dispute. The document becomes part of a patient's chart.
The top of a partogram provides basic patient information including name, age, general health, and other topical data. The form starts with a zero hour, when the patient started experiencing contractions or when a doctor induced labor, and care providers record new data at regular intervals. Partograms can include information about contractions, medications used during labor, fetal health, and maternal health. Any interventions will be noted, ranging from offering fluids to the mother to manually rupturing the amniotic membranes.
This document offers a detailed look at a glance. A care provider can check the partogram to see if labor is progressing normally. This will allow him to identify any problems, such as variations in fetal heart rate that might be indicative of distress. In the case of patients with a history of multiple pregnancies, it is possible to compare the document with older partograms to see if the patient's labor appears to be abnormal when compared with previous deliveries.
Electronic charting equipment can automatically record some data on the partogram, if the patient is connected to monitors for blood pressure, fetal heart rate, and similar data. The program can also prompt care providers to enter data on a schedule to make sure the document is complete. At the end of the labor, it can generate both printed and electronic records to make the information available.
If a partogram shows signs of a problem, care providers can act very rapidly to address it. This may include anything from trying to manually turn a fetus to resolve a problem with the position, to deciding on a Caesarian section to address signs of fetal distress by getting the baby out. Hospitals may have a specific protocol for steps obstetrical teams should take in various situations, with the goal of standardizing care to reduce the risk of complications.
Legal liability is a concern in hospitals, particularly in obstetric settings, and the partogram can be a valuable legal record as well as a medical one. In the event of a lawsuit or dispute, the document will provide a wealth of information about the case and whether care providers handled it appropriately.
