A O Fawole1, O Fadare. 1. Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Nigeria.
Abstract
OBJECTIVE: To assess whether parity influences progress of labour between primigravidae and multiparae as recorded on the partgraph. PATIENT AND METHODS: Retrospective analysis of partographs of women who were monitored with partograph prior to delivery. Participants were selected using specified exclusion criteria. RESULTS: Out of the 1,319 deliveries in the year 2004, 445 women had partographic monitoring; 368 medical records were retrieved and analysed. There were 136 (37.0%) primigravidae and 232 (63.0%)multiparae. The two groups were similar in booking status and risk level. Primigravidae had lower rates of spontaneous labour onset (78.7%) and thus higher rates of induction labour (21.3%) than multiparae [p< 0.05; OR.51, 95% Cl (0.28 - 0.93). Primigravidae presented at lower cervical dilatations and had more frequent vaginal examination than multiparae. Most multiparae (78.2%) had delivered within 6 hours of admission compare with primigravidae (53.1%); prolonged labour occurred more frequently in primigravidae than multiparae (6.9% vs 1.8%). These differences were statistically significant (p=0.000). Higher rates of inadequate uterine contractions were noted among primigravidae. Primigravidae more frequently crossed the alert and reached the action lines compared with multiparae; higher rates of augmentation of labour and emergency caesarean section were also recorded among primigravidae. The outcomes for mother and infant were similar in the two groups. CONCLUSION: Primigravidae are at a higher risk of dystocia compared with the multipara. Quality monitoring of the primigravida with the partograph will reduce the morbidity and mortality in both mother and the newborn.
OBJECTIVE: To assess whether parity influences progress of labour between primigravidae and multiparae as recorded on the partgraph. PATIENT AND METHODS: Retrospective analysis of partographs of women who were monitored with partograph prior to delivery. Participants were selected using specified exclusion criteria. RESULTS: Out of the 1,319 deliveries in the year 2004, 445 women had partographic monitoring; 368 medical records were retrieved and analysed. There were 136 (37.0%) primigravidae and 232 (63.0%)multiparae. The two groups were similar in booking status and risk level. Primigravidae had lower rates of spontaneous labour onset (78.7%) and thus higher rates of induction labour (21.3%) than multiparae [p< 0.05; OR.51, 95% Cl (0.28 - 0.93). Primigravidae presented at lower cervical dilatations and had more frequent vaginal examination than multiparae. Most multiparae (78.2%) had delivered within 6 hours of admission compare with primigravidae (53.1%); prolonged labour occurred more frequently in primigravidae than multiparae (6.9% vs 1.8%). These differences were statistically significant (p=0.000). Higher rates of inadequate uterine contractions were noted among primigravidae. Primigravidae more frequently crossed the alert and reached the action lines compared with multiparae; higher rates of augmentation of labour and emergency caesarean section were also recorded among primigravidae. The outcomes for mother and infant were similar in the two groups. CONCLUSION: Primigravidae are at a higher risk of dystocia compared with the multipara. Quality monitoring of the primigravida with the partograph will reduce the morbidity and mortality in both mother and the newborn.