Introduction: manner and time of intervening labor management caused difficulty in decision making in labor cares. This study was conducted to assess the result of using PARTOGRAM in labor management and recognition of abnormal labor and appropriate intervention time.Methods: In this prospective clinical trail, 200 primigravid women who admitted in alborz hospital of karaj in 1995-1996 were randomly divided into case group and control group. PARTOGRAM was recorded for all patients and in the case group, decision-making was based upon the resulting curve, but in control group decision making was based on routine care without using PARTOGRAM. Collected data were analyzed by using SPSS 13 software and t-test, Chi-square test and Mann-whitney test.Results: Mean length of first stage of labor in case group (208.71±33.8) was significantly lower than control group (289.26±20.3) (P=0.0001), but mean length of second stage of labor was not significantly different in two groups.Total length of labor was significantly shorter in case group (P=0.0001). there was significantly higher rate of cesarean section in case group (P=0.042).first minute Apgar score was significantly higher in the case group (P=0.014).Conclusion: PARTOGRAM, causes a decrease in length of labor and corrects the time of intervention and is beneficial in better decision making in labor management and therefore reduces the complications of abnormal and prolonged labor and is useful as a means of labor management in correct decision making in labor cares.

Background: A major problem of the first moments of childbirth, especially in “prolonged labor,” is perinatal asphyxia which necessitates neonatal resuscitation. This study aimed at evaluating the alert line of the PARTOGRAM in recognizing the need for neonatal resuscitation 20–30 s after delivery.Materials and Methods: 140 full-term pregnant women were kept under surveillance through using a PARTOGRAM. In order to decide on the onset of resuscitation, the three indicators of fetal respiration, heart rate, and skin color were used 20-30 s after delivery.The findings from the evaluation of fetal conditions were compared to the position of the ultimate cervical dilatation graph to the alert line of the PARTOGRAM, and through using appropriate statistical procedures, sensitivity, specificity, and positive and negative prediction values of the alert line to recognize the need for neonatal resuscitation were computed.Results: There was a significant relationship between the need for neonatal resuscitation within 20–30 seconds after delivery and the graph of the cervical dilatations on the PARTOGRAM (P=0.001). The indices of the alert line for predicting the need for resuscitation 20-30 s after birth had a sensitivity of 97.5%, specificity of 80.2%, positive prediction value of 97.2%, and negative prediction value of 98.7%.Conclusions: In mothers who had normal vaginal delivery, with normal fetal heart rate, and with no oxytocin administration or omniotomy, the alert line showed appropriate sensitivity, specificity, and negative prediction value. So, it can assist in predicting the necessity of action for neonatal resuscitation 20-30 s after delivery.

This study was designed to detect the effect of ethnicity, average length of active phase, second stage and third stage in labour duration in healthy parturients of Bandar Abbas. A sample of 795 healthy 13-15 years old parturients with singelton term infants, without any drug, oxygen, conducted anesthesia, previous caesarian delivery, forceps or vacuum:application was collected and the length of active phase, second and third stages were measured to compare with labor lengths in other nations. Furthermore, an PARTOGRAM based on the data was made to compare our findings with other populations. The results showed that active phase average was 4.9 hours (SD=3) for primiparas and 2.8 hours (SD=2) for multiparas. Second stage average duration for primiparous and multiparous was 30 minutes (SD=24) and 10 minutes (SD=9.3), respectively. Compare to Friedman study population, Bandar Abbas parturients showed significantly shorter duration of second stage for both groups (p<0.0001 for primiparas and p<0.0005 for multiparas) whereas, duration of third stage and active phase were significantly longer (p<0.0005 & p<0.01, respectively) in multiparas, but did not showed any significant difference in primiparas (p<0.05). Moreover, the shape of dilatation per hour in (PARTOGRAM) was identical to that of Friedman study. In comparison with other populations, duration of first stage and second stage were shorter (p<0.0005) but third stage was longer (p<0.0005). In conclusion, it seems that labour procedure should be partially managed with respect to ethnicity and race.  

Background and aim: The early diagnosis of abnormal progress of labour and prevention of long term delivery are the main keys to reduce fetal mortality rate due to hypoxia and tissue ischemia. One of the WHO’s proposed methods for prevention of abnormal delivery is using PARTOGRAM. Therefore, this survey was conducted to evaluate WHO's PARTOGRAM alert line for APGAR score at the first minute after birth.Methods: This descriptive–analytical study was performed on 140 pregnant women under PARTOGRAM in Shahrood Fatemieh hospital. Using the PARTOGRAM alert line, the progress of labour, mother's and infant's condition started to be controled from 3 cm dilation of the cervix. Decision for resuscitation was made based on respiration, heart rate and skin color of the infant 20 to 30 seconds after the birth. Tools of this research were a questionnaire, inspection form consisted of WHO's PARTOGRAM and step by step resuscitation form. χ2, t–test and analytical methods of sensitivity, specificity and negative and positive values were used for data analysis.Results: The results showed that 68.8% of the subject's cervical dilatation remained on or to the left side of the alert line and 28.6% was on the right side and 2.9% was on or to the right side of the active line.According to χ2 test, there was a significant relationship between the first minute APGAR score after delivery and the location of cervical dilation. The value of alert line for surveying of APGAR score at the first minute after birth had a sensitivity of 25%, specificity of 96.87%, negative and positive predictive value of 75.6% and 76.92%, respectively.Conclusion: Our results showed that using WHO's PARTOGRAM prevents long term delivery, helps for on time diagnosis of fetal distress and reduction in stillbirth and fetal mortality. So, PARTOGRAM should be a part and parcel of fetal and maternal health care.