Evaluation of WHO's partogram alert line for prediction of the APGAR score at the first minute after birth

The early diagnosis of abnormal progress of labour and prevention of long term delivery are the main keys to reduce fetal mortality rate due to hypoxia and tissue ischemia. One of the WHO’s proposed methods for prevention of abnormal delivery is using partogram. Therefore, this survey was conducted to evaluate WHO’s partogram alert line for APGAR score at the first minute after birth. This descriptive–analytical study was performed on 140 pregnant women under partogram in Shahrood Fatemieh hospital. Using the partogram alert line, the progress of labour, mother’s and infants condition started to be controled from 3 cm dilation of the cervix. Decision for resuscitation was made based on respiration, heart rate and skin color of the infant 20 to 30 seconds after the birth. Tools of this research were a questionare, inspection form consisted of WHO’s partogram and step by step resuscitation form. χ2, t–test and analytical methods of sensitivity, specificity and negative and positive values were used for data analysis. The results showed that 68.8% of the subjects cervical dilatation remained on or to the left side of the alert line and 28.6% was on the right side and 2.9% was on or to the right side of the active line. According to χ2 test, there was a significant relationship between the first minute APGAR score after delivery and the location of cervical dilation. The value of alert line for surveying of APGAR score at the first minute after birth had a sensitivity of 25%, specificity of 96.87%, negative and positive predictive value of 75.6% and 76.92%, respectively. Our results showed that using WHO’s partogram prevents long term delivery, helps for on time diagnosis of fetal distress and reduction in stillbirth and fetal mortality. So, partogram should be a part and parcel of fetal and maternal health care.