Comparing Different Partograph Designs for Use in Standard Labor Care: A Pilot Randomized Trial

Lee, Nigel J., Neal, Jeremy, Lowe, Nancy K. and Kildea, Sue V. (2017) Comparing Different Partograph Designs for Use in Standard Labor Care: A Pilot Randomized Trial. Maternal and Child Health Journal, 22 3: 1-9. doi:10.1007/s10995-017-2366-0

Author Lee, Nigel J.
Neal, Jeremy
Lowe, Nancy K.
Kildea, Sue V.
Title Comparing Different Partograph Designs for Use in Standard Labor Care: A Pilot Randomized Trial
Journal name Maternal and Child Health Journal   Check publisher's open access policy
ISSN 1573-6628
Publication date 2017-09-01
Sub-type Article (original research)
DOI 10.1007/s10995-017-2366-0
Open Access Status Not yet assessed
Volume 22
Issue 3
Start page 1
End page 9
Total pages 9
Place of publication New York, NY United States
Publisher Springer New York
Language eng
Subject 2713 Epidemiology
2735 Pediatrics, Perinatology, and Child Health
2729 Obstetrics and Gynaecology
2739 Public Health, Environmental and Occupational Health
Abstract Backgound Partographs are used in many labour settings to provide a pictorial overview of a woman’s cervical dilation pattern in the first stage of labor and to alert clinicians to slow progress possibly requiring intervention. Recent reviews called for large trials to establish the efficacy of partographs to improve birth outcomes whilst highlighting issues of clinician compliance with use. Previous studies have also reported issues with participant recruitment related to concerns regarding the possibility of a longer labour. Objectives We sought to compare a standard partograph with an action line, to a newly designed partograph with a stepped line, to determine the feasibility of recruitment to a larger clinical trial. Methods A pragmatic, single-blind randomised trial wherein low-risk, nulliparous women in spontaneous labour at term were randomized to an action-line or stepped-line partograph. First stage labour management was guided by the allocated partograph. Primary outcomes included the proportion of eligible women recruited, reasons for failed recruitment and compliance with partograph use. Secondary outcomes included rates of intervention, mode of birth, maternal and neonatal outcomes. Results Of the 384 potentially eligible participants, 38% (149/384) were approached. Of these 77% (116/149) consented, with 85% (99/116) randomized, only nine women approached (6%) declined to participate. A further 9% (14/149) who were consented antenatally were not eligible at onset of labor and 7% (10/149) of women approached in the birth suite but did not meet the inclusion criteria. Compliance with partograph completion was 65% (action) versus 84% (dystocia line). Conclusions for Practice Participant recruitment to a larger randomized controlled trial comparing new labour management guidelines to standard care is feasible. Effective strategies to improve partograph completion compliance would be required to maintain trial fidelity.
Keyword Action line partograph
First stage labor
Labor dystocia
Stepped line partograph
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID 1
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Mater Research Institute-UQ (MRI-UQ)
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School of Nursing, Midwifery and Social Work Publications
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