[Impact of the introduction of a partogram on maternal and perinatal mortality. Study performed in a maternity clinic in Niameny, Niger].

Abstract

Maternal mortality remains one of the major problems in public health today especially in developing countries where maternal mortality is estimated to be between 500 and 1000 deaths for 100,000 live births. In 1987, the safe motherhood initiative was launched with the objective of reducing maternal mortality by 50% within ten years. One of the methods introduced to reduce the high incidence of maternal and neonatal mortality in developing countries, is the partogram, a visual means used in evaluating a normal delivery. It acts as an early warning system, allowing for the early detection of abnormal evolution in labour as well for the mother as for the foetus. This instrument was introduced in all the maternity wards in Niger in 1990 by the Ministry of Public Health. A study was conducted in one of the maternities of the capital to ascertain the effectiveness of this new instrument to both the mother during labor and the newborn child. 1299 women in labor, primi-and multiparous, participated in the study. Two groups were formed: one consisted of women that delivered prior to the introduction of the partogram, the second group was comprised of women who delivered after its introduction. The results of this study have shown that the introduction of the partogram: reduces the amount of time that a women is in labor, improves the follow-up care the pregnant woman receives, results in a more timely decision made by the health official, and consequently, a prompt referral to a specialised center. The authors estimate that, if used correctly, the introduction of this instrument can have along with other appropriate measures, a considerable impact in the reduction of maternal and neonatal mortality.