Evaluation of second stage partogram in predicting outcome in labour and foetal outcome in low risk pregnant women

Abstract

Background: The first stage of labour is monitored by the WHO partogram and it stops thereafter. The second stage of labour is not graphically represented and is monitored by arbitrary time limits rather than true measures of progress making additional variables necessary to assess the progress of labour like descent and position. Objectives: To evaluate a second stage partogram and to observe the outcome of labour in low risk pregnant women based on score at onset of second stage and second stage duration. Methods: A prospective observational study was done at St. Philomena’s hospital, Bangalore during August 2021 to July 2023. 1000 cases of low risk pregnant women with singleton, cephalic presentations were monitored with the second stage partogram. The maternal and foetal outcome were recorded. From onset of second stage of labour, vaginal examinations were done after half an hour and every 15 min till delivery in primigravida and after every 15 min in multigravida. A scoring system based on station and position of foetal head which was developed by Sizer et al was used to plot on a second stage partogram. The outcome of labour was noted. Results: The median duration of second stage of labour for primigravidas and multigravidas were 29.7 min & 22.3 min respectively. The median Sizer‘s partogram score at the onset of second stage was 4. There was a significant association between scores at onset of second stage, second stage duration and outcome in labour. Conclusion: The second stage partogram would be an effective tool to assess the outcome of labour based on combined scoring of station and position of the foetal head at the onset of second stage of labour