Comparative analysis of partogram utility in monitoring labor progress among primigravida and multigravida women. A prospective observational study.

Somwanshi Sonal  Tukaram; Dr Nidhi; ujjwal sourav

doi:10.51168/sjhrafrica.v6i9.2085

Authors

Dr Somwanshi Sonal Tukaram Assistant professor, Department of OBGY, TNMC & BYL Nair Hospital, Mumbai
Dr. Nidhi Consultant OBGY, M B Health care, Noida, UP
Dr. Ujjwal Sourav Associate professor, Department of community medicine, Amrita School of Medicine, Faridabad

DOI:

https://doi.org/10.51168/sjhrafrica.v6i9.2085

Keywords:

Partogram, primigravida, multigravida, labor progress, maternal outcome, neonatal outcome

Abstract

Background:

The partogram is a simple yet effective tool for monitoring labor, designed to detect deviations from normal progression and improve maternal and neonatal outcomes. Despite its proven benefits, routine utilization remains inconsistent in many low- and middle-income settings.

Objective:

To compare the effectiveness of partogram monitoring in primigravida and multigravida women by assessing labor progress, maternal interventions, and neonatal outcomes.

Methods:

Prospective observational study included 200 women (primigravida and multigravida) admitted in labor at a tertiary care hospital in West Bengal. Eligible participants were term singleton cephalic pregnancies in spontaneous or induced labor with cervical dilatation ≤7 cm. Exclusion criteria were multiple gestations, malpresentations, previous uterine surgery, and significant obstetric or medical complications. Labor progress was monitored using a standard partogram, and maternal, intrapartum, and neonatal outcomes were recorded and analyzed.

Results:

Primigravida women were significantly younger (23.8 ± 3.4 vs. 26.5 ± 3.9 years, p = 0.002), with a higher proportion of booked cases (72% vs. 65%, p = 0.18). The mean duration of the first stage of labor was longer in primigravida (7.07 ± 3.1 hrs) compared to multigravida (5.08 ± 3.1 hrs), and the second stage was also prolonged (30.3 ± 15.3 vs. 16.0 ± 15.1 min; both p < 0.05). Spontaneous vaginal delivery rates were higher in multigravida, while operative interventions were more common in primigravida. Neonatal outcomes were comparable, with no significant difference in Apgar scores (1-min: 7.5 ± 0.6 vs. 7.6 ± 0.5, p = 0.42; 5-min: 8.9 ± 0.4 vs. 9.0 ± 0.3, p = 0.35).

Conclusion:

Partogram use enabled early recognition of abnormal labor, improving intrapartum decision-making. Multigravida experienced shorter labor and fewer interventions.

Recommendations:

Routine partogram use should be emphasized, with closer monitoring of primigravida, regular staff training, integration into standard protocols, and further multicentric research to strengthen evidence.

Author Biographies

Dr Somwanshi Sonal Tukaram, Assistant professor, Department of OBGY, TNMC & BYL Nair Hospital, Mumbai

is an Assistant Professor in the Department of Obstetrics and Gynecology at TNMC & BYL Nair Hospital, Mumbai, with expertise in high-risk pregnancy and intrapartum care.

Dr. Nidhi , Consultant OBGY, M B Health care, Noida, UP

is a Consultant in Obstetrics and Gynecology at M B Health Care, Noida, Uttar Pradesh, with a special interest in maternal health and evidence-based clinical practice.

Dr. Ujjwal Sourav, Associate professor, Department of community medicine, Amrita School of Medicine, Faridabad

is an Associate Professor in the Department of Community Medicine at Amrita School of Medicine, Faridabad, with research interests in epidemiology, maternal and child health, and clinical research methodology.

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