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    Partogram Case Studies

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    nyangara
    The document describes three case studies of women in labor. Case 1 involves Mrs. A, who is admitted in the latent phase of labor. Her cervix dilates from 2 to 5 cm over 8 hours. She enters the active phase with regular contractions and normal vital signs. Her labor progresses normally, with the baby delivered after 5 hours in the active phase. Case 2 involves Mrs. B, whose labor is augmented with oxytocin due to slow progress. Her cervix dilates from 4 to 10 cm over 5 hours in the active phase. Case 3 involves Mrs. C, whose labor progresses normally from admission in the active phase until the information given.

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    © All Rights Reserved
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    Partogram Case Studies

    Uploaded by

    nyangara
    277 views6 pages
    The document describes three case studies of women in labor. Case 1 involves Mrs. A, who is admitted in the latent phase of labor. Her cervix dilates from 2 to 5 cm over 8 hours. She enters the active phase with regular contractions and normal vital signs. Her labor progresses normally, with the baby delivered after 5 hours in the active phase. Case 2 involves Mrs. B, whose labor is augmented with oxytocin due to slow progress. Her cervix dilates from 4 to 10 cm over 5 hours in the active phase. Case 3 involves Mrs. C, whose labor progresses normally from admission in the active phase until the information given.

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    partograph cases

    Original Title

    Partogram Case Studies (1)

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    The document describes three case studies of women in labor. Case 1 involves Mrs. A, who is admitted in the latent phase of labor. Her cervix dilates from 2 to 5 cm over 8 hours. She enters the active phase with regular contractions and normal vital signs. Her labor progresses normally, with the baby delivered after 5 hours in the active phase. Case 2 involves Mrs. B, whose labor is augmented with oxytocin due to slow progress. Her cervix dilates from 4 to 10 cm over 5 hours in the active phase. Case 3 involves Mrs. C, whose labor progresses normally from admission in the active phase until the information given.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    277 views6 pages

    Partogram Case Studies

    Uploaded by

    nyangara
    The document describes three case studies of women in labor. Case 1 involves Mrs. A, who is admitted in the latent phase of labor. Her cervix dilates from 2 to 5 cm over 8 hours. She enters the active phase with regular contractions and normal vital signs. Her labor progresses normally, with the baby delivered after 5 hours in the active phase. Case 2 involves Mrs. B, whose labor is augmented with oxytocin due to slow progress. Her cervix dilates from 4 to 10 cm over 5 hours in the active phase. Case 3 involves Mrs. C, whose labor progresses normally from admission in the active phase until the information given.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 6

    Case Studies: Using the Partogram

    CASE 1
    Instructions: The group members should systematically go through each step below and plot the
    information on their individual partograms. Answer the questions associated with each step for Mrs.
    A.

    STEP 1: Mrs. A was admitted at 05.00 on 19 September 2015. Membranes ruptured at 04.00. She is
    a gravida 3, para 2+0. The hospital number is 7886. On admission, the fetal head was 4/5 palpable
    above the symphysis pubis and the cervix was 2 cm dilated. Contractions are 2 in 10, lasting 25
    seconds.

    Q: What should be recorded on the partogram?


    Note: Mrs. A is not in the active phase of labor. Record the details of her history, contractions, and
    your examination findings. If you are using a partogram that allows for observations of the latent
    phase of labor, record your findings on the partogram. If not, record your findings in the mother’s
    case notes. She is due for another vaginal examination in 8 hours or earlier if spontaneous rupture of
    the membrane occurs.

    --------------------------------
    STEP 2: It is 13.00 (8 hours later). The fetal head is 3/5 palpable above the symphysis pubis. The
    cervix is 5 cm dilated.

    Q: What should you now record on the partogram?

    --------------------------------
    STEP 3: Mrs. A is now in the active phase of labor. Note the phase of labor and plot the following
    information on the partogram:
     3 contractions in 10 minutes, each lasting 40 seconds
     Fetal heart rate (FHR) 120
     Membranes ruptured, amniotic fluid clear on pad check
     Sutures of the skull bones are apposed (molding +), no caput
     Blood pressure 120/70 mmHg
     Temperature 36.8°C
     Pulse 80/minute
     Urine output 200 mL; negative protein and acetone

    Answer the following questions:

    Q: What steps should be taken?

    Q: What advice should be given?

    Q: What do you expect to find at 17.00?

    Partogram Case studies 1


    ----------------------
    STEP 4: Labor monitoring is ongoing over the next four hours. Plot the following information on the
    partogram:
    09.30 FHR 120, Contractions 2/10 each 30 seconds, Pulse 80/minute
    10.00 FHR 136, Contractions 2/10 each 30 seconds, Pulse 80/minute
    10.30 FHR 140, Contractions 2/10 each 35 seconds, Pulse 88/minute
    11.00 FHR 130, Contractions 2/10 each 40 seconds, Pulse 88/minute, Temperature 37°C
    11.30 FHR 136, Contractions 3/10 each 40 seconds, Pulse 84/minute, Head is 2/5 palpable
    12.00 FHR 140, Contractions 3/10 each 40 seconds, Pulse 88/minute
    12.30 FHR 130, Contractions 3/10 each 45 seconds, Pulse 88/minute
    13.00 FHR 140, Contractions 3/10 each 45 seconds, Pulse 90/minute, Temperature 37°C

     13.00:
    – The fetal head is 2/5 palpable above the symphysis pubis
    – The cervix is 5 cm dilated
    – Amniotic fluid is clear
    – Sutures apposed
    – Blood pressure 100/70 mmHg
    – Urine output 150 mL; negative protein and acetone

    Answer the following questions:

    Q: What steps should be taken?

    Q: What advice should be given?

    Q: What do you expect to happen next?

    -----------------------------
    STEP 5: Vaginal assessment at 17.00 shows that the cervix is now fully dilated and the head has
    descended to 0/5. Mrs. A now feels expulsive. Record the following information on the partogram:

     17.20: Spontaneous birth of a live female infant weighing 2,850 g

    Answer the following questions:

    Q: How long was the active phase of the first stage of labor?

    Q: How long was the expulsive phase of the second stage of labor?

    Partogram Case studies 2


    CASE 2
    Instructions: The group should systematically go through each step below and plot the information
    on each participant’s individual partogram. Answer the questions associated with each step for Mrs.
    B.

    STEP 1. Mrs. B was admitted at 10.00 on 19 September 2013. She is gravida 1, para 0+0. Her
    membranes are intact. The hospital number is 1443.

    Record the personal history details above on the partogram, together with the following details:
     The fetal head is 3/5 palpable above the symphysis pubis
     The cervix is 4 cm dilated
     2 contractions in 10 minutes, each lasting for 30 seconds
     FHR 140
     Membranes intact
     Blood pressure 100/70 mmHg
     Temperature 36.2°C
     Pulse 80/minute

    Answer the following questions:

    Q: What is your diagnosis?

    Q: What action will you take?

    -------------------------------
    STEP 2: Plot the following information on the partogram for Mrs. B:
    10.30 FHR 140, Contractions 2/10 each 25 sec, Pulse 90/minute
    11.00 FHR 136, Contractions 2/10 each 15 sec, Pulse 88/minute
    11.30 FHR 140, Contractions 2/10 each 30 sec, Pulse 84/minute
    12.00 FHR 136, Contractions 2/10 each 30 sec, Pulse 88/minute, Temperature 36.2°C, Membranes
    intact. The fetal head is 5/5 palpable above the symphysis pubis. The cervix is 4 cm dilated.

    Answer the following questions:

    Q: What is your diagnosis?

    Q: What action will you take?

    --------------------
    STEP 3. Plot the following information on the partogram:
    12.30 FHR 136, Contractions 2/10 each 30 seconds, Pulse 90/minute
    13.00 FHR 140, Contractions 2/10 each 30 seconds, Pulse 88/minute
    13.30 FHR 130, Contractions 2/10 each 30 seconds, Pulse 88/minute
    14.00 FHR 140, Contractions 2/10 each 30 seconds, Pulse 90/minute, Temperature 36.8°C, Blood
    pressure 100/70 mmHg. The fetal head is 3/5 palpable above the symphysis pubis. Urine
    output 300 mL; negative protein and acetone.

    Partogram Case studies 3


    Answer the following questions:

    Q: What is your diagnosis?

    Q: What will you do?

    STEP 4: Plot the following information on the partogram:


     14:00:
    – The cervix is 4 cm dilated, sutures apposed
    – Labor augmented with oxytocin 2.5 units in 500 mL IV fluid at 10 drops per minute (dpm)
    – Membranes artificially ruptured, clear fluid

     14.30:
    – 2 contractions in 10 minutes, each lasting 35 seconds
    – Infusion rate increased to 20 dpm
    – FHR 140, Pulse 90/minute

     15.00:
    – 3 contractions in 10 minutes, each lasting 40 seconds
    – Infusion rate increased to 30 dpm
    – FHR 140, Pulse 90/minute

     15:30:
    – 3 contractions in 10 minutes, each lasting 45 seconds
    – Infusion rate increased to 40 dpm
    – FHR 140, Pulse 88/minute

     16.00:
    – Fetal head now 2/5 palpable above the symphysis pubis
    – Cervix 6 cm dilated; sutures apposed
    – 3 contractions in 10 minutes, each lasting 45 seconds
    – Infusion rate maintained at 40 dpm
    – FHR 144, Pulse 92/minute
    – Amniotic fluid clear

     16.30:
    – 3 contractions in 10 minutes, each lasting 45 seconds
    – FHR 140, Pulse 90/minute
    – Infusion increase to 50 dpm

    Q: What steps would you take?

    Partogram Case studies 4


    ------------------------------
    STEP 5. Plot the following information on the partogram:
     17.00 FHR 138, Pulse 92/minute, Contractions 3/10 each 45 seconds, Maintain at 50 dpm
     17.30 FHR 140, Pulse 94/minute, Contractions 3/10 each 45 seconds, Maintain at 50 dpm
     18.00 FHR 140, Pulse 96/minute, Contractions 4/10 each 50 seconds, Maintain at 50 dpm
     18.30 FHR 144, Pulse 94/minute, Contractions 4/10 each 50 seconds, Maintain at 50 dpm

    ------------------------------
    STEP 6. Plot the following information on the partogram:
     19.00:
    – Fetal head 0/5 palpable above the symphysis pubis
    – 4 contractions in 10 minutes, each lasting 50 seconds
    – FHR 144, Pulse 90/minute
    – Cervix fully dilated. Mother feels expulsive.

    ------------------------------
    STEP 7. Record the following information on the partogram:
     19.30:
    – 4 contractions in 10 minutes, each lasting 50 seconds
    – FHR 142, Pulse 100/minute

     20.00:
    – 4 contractions in 10 minutes, each lasting 50 seconds
    – FHR 146, Pulse 110/minute
    – Spontaneous birth of a live male infant weighing 2,654 g

    Answer the following questions:

    Q: How long was the active phase of the first stage of labor?

    Q: How long was the second stage of labor?

    Q: Why was labor augmented?

    Partogram Case studies 5


    CASE 3
    STEP 1. Mrs. C was admitted at 10.00 on 19 September 2013 at Kahama District Hospital.
    Membranes ruptured spontaneously at 04.00. She is a gravida 4, para 3+0.

    Record the information above on the partogram, together with the following details:
     Fetal head 3/5 palpable above the symphysis pubis
     Cervix 4 cm dilated
     3 contractions in 10 minutes, each lasting 30 seconds
     FHR 140
     Amniotic fluid clear
     Sutures apposed (Molding +)
     Blood pressure 120/70 mmHg
     Temperature 36.8°C
     Pulse 80/minute

    STEP 2. Plot the following information in the partogram:


     10.30 FHR 130, Contractions 3/10 each 45 seconds, Pulse 80/minute
     11.00 FHR 136, Contractions 3/10 each 45 seconds, Pulse 90/minute
     11.30 FHR 140, Contractions 3/10 each 45 seconds, Pulse 88/minute
     12.00 FHR 140, Contractions 3/10 each 45 seconds, Pulse 90/minute, Temperature 37°C,
    Head 3/5 palpable
     12.30 FHR 130, Contractions 3/10 each 45 seconds, Pulse 90/minute
     13.00 FHR 130, Contractions 3/10 each 50 seconds, Pulse 88/minute
     13.30 FHR 120, Contractions 3/10 each 50 seconds, Pulse 88/minute
     14.00 FHR 130, Contractions 3/10 each 50 seconds, Pulse 90/minute, Temperature 37°C,
    Blood Pressure 100/70 mmHg. Fetal head 3/5 palpable above the symphysis pubis. Cervix 6
    cm dilated, amniotic fluid clear. Sutures overlapped but reducible (Molding ++).

    STEP 3. Plot the following information in the partogram:


     14.30 FHR 120, Contractions 3/10 each 45 seconds, Pulse 90/minute, Clear fluid
     15.00 FHR 120, Contractions 3/10 each 45 seconds, Pulse 88/minute, Blood-stained fluid
     15.30 FHR 100, Contractions 3/10 each 45 seconds, Pulse 100/minute
     16.00 FHR 90, Contractions 3/10 each 50 seconds, Pulse 100/minute, Temperature 37°C
     16.30 FHR 96, Contractions 4/10 each 50 seconds, Pulse 110/minute. Fetal head 3/5
    palpable above the symphysis pubis. Cervix 6 cm dilated. Amniotic fluid meconium stained.
    Sutures overlapped and not reducible. Urine output 100 mL; protein negative, acetone 1+.

    STEP 4. Record the following information on the partogram:


     Cesarean section at 17.30, live female infant with poor respiratory effort and weighing
    4,850g.

    Partogram Case studies 6

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