World Health Organization : Year 1993 ; World Health Organization, Family Health, Maternal and Newborn Health-Safe Motherhood, No. 93.11: Preventing Prolonged Labour ; A Practical Guide the Partograph Part IV ; Guidelines for Operations Research

By Christopher E. Lennox

Book Id: WPLBN0000101601
Format Type: PDF eBook
File Size: 1.0 MB
Reproduction Date: 2005

Title:	World Health Organization : Year 1993 ; World Health Organization, Family Health, Maternal and Newborn Health-Safe Motherhood, No. 93.11: Preventing Prolonged Labour ; A Practical Guide the Partograph Part IV ; Guidelines for Operations Research
Author:	Christopher E. Lennox
Volume:
Language:	English
Subject:	Health., Public health, Wellness programs
Collections:	Medical Library Collection, World Health Collection
Historic Publication Date:
Publisher:	World Health Organization


Citation APA MLA Chicago Lennox, C. E. (n.d.). World Health Organization : Year 1993 ; World Health Organization, Family Health, Maternal and Newborn Health-Safe Motherhood, No. 93.11. Retrieved from http://gutenberg.cc/

Description
Medical Reference Publication

Excerpt
1. INTRODUCTION The tragedies of obstructed labour and rupture of the uterus comprise one of the five major causes of maternal mortality and morbidity in developing countries. The number of maternal deaths due to obstructed labour and/or rupture of the uterus varies between 4% and 70% of all maternal deaths, amounting to a maternal mortality rate as high as 4101100 000 live births. The phenomena of obstructed labour and rupture of the uterus have been described extensively since the early 1950s. The literature suggests that in many countries maternal mortality due to these causes is almost as severe in the 1990s as it was 30 years ago. In addition, significant maternal morbidity is associated with prolonged labour, since both postpartum haemorrhage and infection are less common in women with short labours. The major constraint to the prevention of prolonged and obstructed labour is the accurate and early recognition of possible cephalopelvic disproportion (CPD) either before or during labour. Particularly in the developing world, all labours should be considered a ma1 of labour, as cephalopelvic disproportion is the most common reason for intervention in the course of labour. In many societies, in the majority of primigravidae, the fetal head is not engaged at the onset of labour even though the pelvis is adequate. For this reason all labours should be monitored closely in order to identify delay at an early stage.

Table of Contents
TABLE OF CONTENTS 1 . INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2 . BACKGROUND TO OPERATIONS RESEARCH . . . . . . . . . . . . . . . . . . . 1 3 . APPROPRIATE CENTRES FOR OPERATIONS RESEARCH . . . . . . . . . . 2 4 . PROTOCOL OBJECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 5 . HYPOTHESES BEHIND OPERATIONS RESEARCH PROTOCOL . . . . . . 3 6 . METHODOLOGY OF OPERATIONS RESEARCH . . . . . . . . . . . . . . . . . . 3 7 . DETAILED METHODOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 7.1 Collection of Data Prior to Introduction of Panograph . . . . . . . . . . . . . 4 7.1.1 Method of data collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 7.1.2 Inclusion/exclusion data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 7.1.3 Data to be collected . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 7.2 Introduction of the Partograph by Means of a Training Programme . . . . 6 7.2.1 Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 7.2.2 Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 7.2.3 Supervision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 7.3 Evaluation of Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 7.4 Collection of Data After Introduction of the Partograph . . . . . . . . . . . . 7 7.5 Data Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 8 . ENDPOINTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 ANNEX 1: SAMPLE DATA COLLECTION FORMS . . . . . . . . . . . . . . . . . . . . . . . 11 1 . Data Collection Prior to Introduction of Partograph . . . . . . . . . . . . . . . 11 1.1 Essential data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 1.2 Data to be collected if possible . . . . . . . . . . . . . . . . . . . . . . . . 12 2 . Data Collection After Introduction of Partograph . . . . . . . . . . . . . . . . . 12 ANNEX 2: SAMPLE RESULTS TABLES FOR OPERATIONS RESEARCH ON THE USE OF THE PARTOGRAPH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 1 . Evaluation of Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 2 . Evaluation of Partograph as a Management Tool for Labour . . . . . . . . . 17 3 . Evaluation of Impact of Partograph on Complications of Labour and Sequelae . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18