partograph components explanation alert action line normal labor

A detailed educational partograph chart for medical students. The chart shows a WHO partograph with a central normal labor graph. Layout: The main partograph grid occupies the center. On the LEFT side are labeled explanations for each row/parameter. On the RIGHT side are clinical interpretation notes. The partograph includes these rows from top to bottom: 1. Fetal Heart Rate (FHR) - grid from 100-180 bpm, plotted every 30 minutes, normal range 110-160 bpm highlighted in green 2. Liquor / Amniotic fluid (I=intact, C=clear, M=meconium, A=absent) 3. Moulding (0, 1+, 2+, 3+) 4. Cervicogram - the central large grid (x-axis: Hours of labor 0-12, y-axis: Cervical dilation 0-10 cm). Shows THREE lines: Alert Line (solid diagonal from 4cm at hour 0 to 10cm at hour 6, drawn in RED), Action Line (parallel to alert line, 4 hours to the right, in BOLD RED/ORANGE), and a plotted Normal Labor curve (green dots connected) progressing from 4cm to full dilation staying LEFT of the alert line 5. Descent of head (5/5 to 0/5 scale) 6. Hours in labor (time axis) 7. Contractions per 10 minutes (shaded boxes showing frequency and duration) 8. Oxytocin drip (if used) 9. Drugs / IV fluids 10. Maternal vitals: Pulse (bold dot), BP (line with arrows up/down), Temperature 11. Urine: Volume, Protein, Acetone LEFT SIDE explanations (neat labeled boxes or callouts): - "Fetal Heart Rate: Record every 30 min. Normal: 110-160 bpm" - "Liquor: I=Intact, C=Clear, M=Meconium staining, A=Absent" - "Moulding: Degree of head overlap at sutures" - "Cervical Dilation: Plot with X. Active phase starts at 4cm" - "Alert Line: Expected rate 1cm/hr. If crossed, consider cause" - "Action Line: 4hrs right of alert line. Intervention mandatory" - "Descent: Fifths of head palpable abdominally (5/5 to 0/5)" - "Contractions: Count per 10 min; shade by duration <20s, 20-40s, >40s" RIGHT SIDE interpretations (neat labeled boxes): - "Normal labor: Cervical progress stays LEFT of Alert Line" - "Slow progress: Curve crosses Alert Line - reassess, do VE" - "Arrest: Curve crosses Action Line - augmentation or CS needed" - "FHR <110 or >160: Fetal distress - urgent review" - "Meconium-stained liquor: Risk of fetal distress" - "Moulding 3+: Possible CPD (cephalopelvic disproportion)" - "Contractions <3 in 10 min: Hypotonic uterine activity" - "Mother: Monitor BP, pulse, temp, urine output regularly" The normal labor curve plotted in green shows: 4cm at start, 5cm at 1hr, 6cm at 2hrs, 7cm at 3hrs, 8.5cm at 4hrs, 10cm at 5hrs - a smooth sigmoid curve well to the LEFT of the Alert Line. Title at top: "PARTOGRAPH - WHO Modified (with Normal Labor Curve)" Subtitle: "A tool for monitoring progress of labour and detecting abnormal patterns early" Use a clean clinical chart style: white background, dark grid lines, color-coded lines (green for normal curve, red for alert line, orange-red for action line), neat sans-serif fonts, professional medical illustration quality.