Author(s): Nyamtema AS, Urassa DP, Massawe S, Massawe A, Lindmark G,
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Abstract OBJECTIVE: To assess the quality of partograms used to monitor labor in Dar es Salaam hospitals, Tanzania. METHODS: The study team reviewed the records of the parameters of labor, and maternal and fetal conditions in 367 partograms, and interviewed 20 midwives. RESULTS: All midwives interviewed had been previously trained to use the partogram. Of all partograms reviewed, 50\% had no records of duration of labor. Although cervical dilation and fetal heart rates were recorded in 97\% and 94\% of the partograms respectively, 63\% and 91\% of these were judged to be substandard. Substandard monitoring of fetal heart rates was strongly associated with poor fetal outcome (P<0.001). Blood pressure, temperature, and pulse rates were not recorded in 47\%-76\% of partograms. CONCLUSION: These findings reflect poor management of labor and indicate urgent in-service training to address the importance of documentation and regular partogram audit in order to reduce maternal and perinatal deaths.
This article was published in Int J Gynaecol Obstet
and referenced in Journal of Pregnancy and Child Health