RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES KARNATAKA, BANGALORE

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1 NAME OF THE CANDIDATE AND ADDRESS

DR. DARSHIT. P. SHETTY,S/O PRAKASHCHANDRA SHETTY,HOTEL RAMESH BHAVAN,NAGASHETTIKOPPA,KESHWAPUR,HUBLI- 580023

2 NAME OF THE INSTITUTION

YENEPOYA MEDICAL COLLEGE, DERALAKATTE, MANGALORE .

3 COURSE OF STUDY AND SUBJECT

POSTGRADUATION INM.S.(OBG),OBSTETRICS & GYNAECOLOGY.

4 DATE OF ADMISSION TO COURSE

31-05-2007

5 TITLE OF TOPIC EVALUATION OF PARTOGRAM IN 50 CASES EACH OF PRIMIGRAVIDA & MULTIGRAVIDA WITH NEONATAL OUTCOME IN LABOUR.

6. BRIEF RESUME OF THE INTENDED WORK:

6.1.NEED FOR THE STUDY: Prolonged Labour In Developing Countries Is Commonly Due To Cephalopelvic Disproportion Which May Result In Obstructed Labour, Maternal Dehydration, Exhaustion, Uterine Rupture Etc. In Some, Abnormal Progress Of Labour Is Often Due To Inefficient Uterine Contraction. Early Detection Of Abnormal Progress Of Labour And Prevention Of Prolonged Labour Significantly Reduces The Maternal & Perinatal Complications. Partogram Is Used To Assess The Progress Of Labour And To Identify When Intervention Is Necessary. Partogram Can Be Highly Effective In Reducing Complications From Prolonged Labour, For Both The Mother & The Newborn. 6.2 REVIEW OF LITERATURE D De Groof, Vangeenderhuysen, T Juncker, Ra Favi1 Had Done A Study On The Impact Of A Partogram On Maternal & Perinatal Mortality In All Maternity Wards In Niger. 1299 Women In Labour, Primi And Multiparous Particiapted In Two Groups; One Prior To & Second After Introduction Of Partogram. Results Showed Introduction Of Partogram Reduces The Labour To Delivery Time, Results In Timely Decision And Improves Follow Up Care. Hence Partogram Has Considerable Impact In Reduction Of Maternal & Neonatal Mortality.

D. M. F. Gibb, L. D. Cardozo, J. W. W. Studd, A. L. Magos, D. J. Cooper2. Had Taken Up A Study On 847 Multigravida Patients Admitted In Spontaneous Labour.Labour Was Monitored With Partogram. The Mean Observed First Stage Was 3.4 Hrs & Caesarean Section Rate 1.4%. Normal Labour Occurred In 88.5% With Vaginal Delivery Rate Of

99.5%Stimulation Indicated In 11.6% With Augmentation Improving Rate Of Progress In 86%. Outcome Was Assessed By Apgar Scores, Intubation And Nicu Admission.There Was No Significant Difference In Neonatal Condition Between Normal & Abnormal Labour If Vaginal Delivery Occurred.

Ganesh Dangal3 Used Partogram To Assess The Progress Of Labour And To Identify When Intervention Is Necessary. Studies Have Shown That Using Partogram Can Be Highly Effective In Reducing Complications From Prolonged Labour For The Mother And For The Newborn.Prolonged Labour, Augmented Labor, Caesarean Sections/Operative Interventions, Neonatal Morbidity And Intrapartum Fetal Deaths Were Reduced With Use Of Partograph.

Iffat Javed, Shereen Bhutta, Tabassum Shoaib4 Had Taken Up Study To Determine The Effct Of Partogram On The Frequency Of Prolonged Labour, Augmented Labour, Operative Deliveries And Whether Appropriate Interventions Based On Partogram Wll Reduce Maternal & Perinatal Complications. A Case Controlled , Prospective And Interventional Study On 1000 Women In Labour Was Carried Out Before And After Introduction Of Partogram. Results Showed Significant Impact On Duration & Mode Of Delivery In Primi & multi. Hence Maternal And Perinatal Morbidity& Mortality Was Reduced.

John Studd5 Constructed A Nomogram To Show The Normal Progressive Dilatation Of The Cervix For Primigravida Admitted At Different Stages Of Cervical Dilatation. Retrospective Evaluation Of The Nomogram Showed That It Can Separate Normal Labour From Labour Destined To Result In An Abnormal Outcome, Such As Longer First And Second Stages, A Greater Incidence Of Instrumental Delivery, And Babies With Low Apgar Scores.

6.3.OBJECTIVE OF THE STUDY:-

1.To Construct A Partogram In Both Primigravida & Multigravida 2.To Assess The Rate Of Cervical Dilatation In Both Primigravida And Multigravida. 3.To Evaluate Role Of Partogram In Preventing Prolonged Labour. 4.To Evaluate The Maternal & Perinatal Outcome In Primigravida And Multigravida By Comparing Their Partograms In Labour.

7.MATERIAL AND METHOD:- 7.1 SOURCE OF DATA:- 50 Cases Each Of Primigravida & Multigravida In Labour Admitted In Department Of Obg, Yenepoya Medical College, Deralakatte, Mangalore During A Period From Nov 2007 To May 2009.

7.2 METHOD OF COLLECTION OF DATA:-

STUDY DESIGN- Prospective Clinical Study

SETTING- Dept. Of Obg, Yenepoya Medical College, Deralakatte.

DURATION OF STUDY- One And Half Yrs From Nov 2007 To May 2009

SAMPLE SIZE-50 Cases Each Of Primigravida And Multigravida.

SAMLING TECHNIQUE-Random Selection Of Subjects Meeting The Inclusion & Exclusion Criteria.

SAMPLE SELECTION:

A)INCLUSION CRITERIA - PREGNANT WOMEN IN SPONTANEOUS ONSET OR INDUCED LABOUR, IN FIRST STAGE OF LABOUR WITH CERVICAL DILATATION OF NOT MORE THAN 7cms , SINGLETON PREGNANCY, >36 WEEKS GESTATION, CEPHALIC PRESENTATION. B)EXCLUSION CRITERIA- ANTEPARTUM HEMORRHAGE, BREECH PRESENTATION, MULTIPLE PREGNANCY, CERVICAL DILATATION > 7cms, PREMATURE LABOUR <36 WEEKS. DATA COLLECTION TOOL- WHO Partograph

7.3 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION Yes

8. REFERENCE’S AND CITATION’S;

1) D De GROOF, VANGEENDERHUYSEN C, T HUNCKER,RA FAVI Impact Of Introduction Of A Partogram On Maternal And Perinatal Mortality. Study Performed In A Maternity Clinic In Niameny, Nijeria. Ann Soc Belg Med Trop. 1995 Dec; 75(4): 321-330 .

2) D. M. F. GIBB, L. D. CARDOZO, J. W. W. STUDD, A. L. MAGOS, D. J. COOPER.

Outcome Of Spontaneous Labour In Multigravidae. Bjog:An International Journal Of Obst&Gynecology September 1982, Vol 89, Issue 9, Page 708-711.

3) GANESH DANGAL; Preventing Prolonged Labour By Using Partograph. The Internet Journal Of Gynecology And Obstetrics. 2007, Volume 7, Number 1.

4) IFFAT JAVED, SHEREEN BHUTTA, TABASSUM SHOAIB. Role Of Partogram In Preventing Prolonged Labour J Pak Med Assoc. August 2007, Vol 57, No.8

5) JOHN STUDD Partograms And Nomograms Of Cervical Dilatation In Management Of Primigravid Labour British Medical Journal, 1973, Vol 4, 451-455.

9.0 SIGNATURE OF THE CANDIDATE:

10.0 REMARKS OF THE GUIDE:-

11.0 NAME AND DESIGNATION:

11.1 GUIDE:- DR.USHA SADASHIVAN, PROF IN DEPT. OF OBG, YMCH, DERALAKATTE. 11.2 SIGNATURE:-

11.3 CO-GUIDE: 11.4 SIGNATURE:

11.5 HEAD OF THE DEPARTMENT: DR.BHARATHI. V. BALIGA, PROF & HOD, DEPT. OF OBG, YMCH, DERALAKATTE.

11.6 SIGNATURE:

12. PRINCIPAL:-DR.R.N.SUJEER, PROF IN DEPT. OF SURGERY, YMCH, DERALAKATTE.

12.1 REMARKS OF PRINCIPAL: -

12.2 SIGNATURE:-