From what cm of cervical dilatation is paogram plotted in regular intervals?
The best method to monitor labour is through the paograph ! The paograph is a graphic record of the progress of labour and relevant details of the mother and fetus The WHO paograph begins only in the active phase of labour, when the cervix is 4 cm or more dilated Observations to be made: Maternal well - being: Pulse every 30 minutes Blood pressure and temperature 4-hourly Urine output and dipstick testing for protein Ketones (if available) and glucose after vooding Fetal well - being: Record fetal hea rate for 1 minute every 15-30 minutes after a contraction in the first stage Every 5 minutes in the second stage If abnormalities are noted, urgent delivery can be considered. Liquor: Clear Meconium stained (thick or thin) Bloody Absent Thick meconium suggests fetal distress Moulding 0= bones are separated and sutures can be easily felt; +1 = bones are just touching each other; +2 = bones are overlapping but can be reduced; +3 = bones are severely overlapping and irreducible. Cervical dilatation:assess at each VAGINAL EXAMINATION and mark with a cross x. Begin at 4 cm. Ale line: staing at 4 cm of cervical dilatation, up to the point of expected full dilatation at the rate of 1 cm per hour. Action line: parallel and 4 hours to the right of the ale line. Descent of head:assessed by abdominal palpation: this refers to the pa of the head (which is divided into five pas) palpable above the symphysis pubis;recorded as a circle (O)at every vaginal examination. At 0/5, the sinciput (S) is at the level of the symphysis pubis. PLEASE NOTE: Newer guidelines are now suggesting onset of active labour and thus initial marking to be plotted at 6 cm dilatation. However till consensus is achieved on this, the previous definition of 4 cm shall be accepted for answering. Students should be on the lookout for such a guideline.
4 cm
5 cm
6 cm
8 cm
Obstetrics