Sample partograph questions
Plot the partograph for the following cases
1. Mrs Audu is in her 5th pregnancy, she has had 1 abortion, 1 stillbirth and a preterm delivery,
Hanatu was born at term and is her only child. Mrs Audu presented to the labour ward 15 th
September 2018 at 3:00am, with a 38 weeks gestation. She had spontaneously ruptured the
fetal membranes one hour earlier. The fetal heart rate at presentation was 140 b/min, she
had 2 contractions in 10 minutes, both lasting 35 seconds and the cervical dilatation was
5cm and the head was 3/5 palpable. She had a blood pressure of 165/110mmHg and pulse
of 100b/min. The requested urinalysis was negative for both protein and sugar. Mrs Audu
was then admitted and administered 10mg Hydralazine slowly. One hour after presentation,
the FHR was 150b/min, the contractions were still the same, she was now commenced on
augmentation of labour with 5iu oxytocin inside 500mls of normal saline at 10 drops per
minute. This was increased by 10 drops upon every subsequent assessment until 1 hour later
when the contractions became adequate. She was found to have cervical dilatation of 9cm
by 7:00am. By 8:00 am she complained of an urge to bear down, repeat vaginal examination
revealed a full cervical dilatation, the FHR was 148b/min. She was encouraged to bear down
and progressed to have vaginal delivery of a live male fetus with APGAR scores 7 and 9 at
the first and fifth minute respectively.
2. Plot the labour activities of this parturient. She is gravid 3, para 2+0, admitted in
latent phase of labour at 5 am.
- fetal head was 4/5 palpable
- cervix was 2 cm dilated
- three contractions in 10 minutes, each lasting 20 seconds
- normal maternal and fetal conditions
At 9 am:
a. fetal head 3/5 palpable
b. cervix was 5cm dilated
c. four uterine contractions in 10 minutes each lasting more than 40 seconds
At 11am:
d. fetal head was 2/5 palpable
e. four uterine contractions in 10 minutes, each lasting 45 seconds
At 2 pm (14 hours):
f. fetal head was now (0/5) palpable
g. cervical dilatation progressed at the rate of more than 1 cm per hour and cervix
fully dilated
h. five contractions in 10 minutes each lasting 45 seconds
i. had a spontaneous vaginal delivery at 1:20pm (14:20hours)
3. Mrs Nwakama is a G3P2 +0 (2A), Hospital number 101530, admitted at 5:00 am on
12/09/2018. She had ruptured membranes spontaneously about 1 hour before
presentation.
She had a cervical dilatation of 6cm at admission. The liquor was clear and there was no
moulding. The fetal head was 3/5 palpable par abdomen and the FHR was 130 bpm
She was having 4 contractions in 10 minutes, each lasting 50 seconds. Her pulse rate was
80bpm, BP = 110/70 mmHg and Temperature = 36.8˚C. She produced 200 ml of urine on
admission and it was negative for protein and acetone. Subsequent FHR readings were :136,
120, 140, 120, 120, 130
Uterine contractions remained the same for the next 3 hours. At 8:00 am, she felt an
irresistible urge to push. Vaginal examination confirmed full cervical dilatation and the fetal
head was on the perineum. She was positioned, encouraged to push and she had SVD of a
live female infant weighing 3.2Kg, with APGAR scores of 9 and 10 at 1 and 5 minutes
respectively.
4. PLOT THE PARTOGRAPH OF ALL THESE EVENTS, WHICH OCCURRED IN LABOUR. Mrs Okoli is
a booked G3P2 +0 (2A), Hospital number 303155, admitted at 5:00 am on 11/02/2018. She
had ruptured membranes spontaneously about 1 hour before presentation.
She had a cervical dilatation of 6cm at admission. The liquor was clear and there was no
moulding.
The fetal head was 3/5 palpable par abdomen and the FHR was 130 bpm
She was having 4 contractions in 10 minutes, each lasting 50 seconds.
Her pulse rate was 80bpm, BP = 110/70 mmHg and Temperature = 36.8˚C.
She produced 200 ml of urine on admission and it was negative for protein and acetone.
Subsequent FHR readings were :136, 120, 140, 120, 120, 130
Uterine contractions remained the same for the next 3 hours.
At 8:00 am, she felt an irresistible urge to push. Vaginal examination confirmed full cervical
dilatation and the fetal head was on the perineum.
She was then positioned, encouraged to bear down and she had SVD of a live female infant
weighing 3.2Kg, with APGAR scores of 9 and 10 at 1 and 5 minutes respectively.
5. PLOT THE PARTOGRAPH OF THESE CLINICAL EVENTS, WHICH OCCURRED IN LABOUR.
Olusola Aweda, a booked, 26 year old, presented to the hospital at 38 weeks gestational
age, by 1:00am on 10th September 2018. She has previously had 1 vaginal delivery of a
male child who is alive and 1 miscarriage. Her hospital number is 000653. At admission, the
fetal head was 3/5 palpable, Fetal Heart Rate (FHR) was 144 beats per minute and she had 2
contractions in 10 minutes lasting 30 seconds each, cervical os was 2cm dilated. Her blood
pressure was 110/80 mmHg.
She was reviewed by 5:00am and the FHR was 148 b/min, the fetal head was 2/5 palpable
and she had cervical dilatation of 4cm, she had voided 200mls of amber coloured urine, her
pulse rate was 88 b/min and the blood pressure was 114/78.
The fetal membrane was then ruptured and 150 mls of clear liquor drained, the fetal skull
bones just touched each other at this time and there was no caput. She had 2 contractions
lasting 30 seconds each. She was given 30mg Pentazocine injection.
An hour later, augmentation of labour was commenced using 5IU of Oxytocin in 500mls of
normal saline, to run at 10 drops/minute, uterine contractions became adequate 1 hour
after commencing oxytocin infusion.
She was reviewed again at 9:00am and found to have 3 adequate contractions in 10 minutes
and cervical dilatation of 8cm. Her temperature was 36.8˚C. The FHR was 152 beats per
minute.
One hour later, she felt an irresistible urge to push. Vaginal examination confirmed full
cervical dilatation and the fetal head was on the perineum.
She was positioned, encouraged to push and she had SVD of a live female infant weighing
3.2Kg, with APGAR scores of 9 and 10 at 1 and 5 minutes respectively.
