The partogram's result and neonatal outcome

Summary

The aim was to investigate to what extent low Apgar scores are linked to the partogram's result and, more specifically, if the action line should be set 3 rather than 4 h parallel and right to the alert line. Some 24.0% of all labours evolved left to the alert line and 26.3% of the labours right to the alert line crossed the 4-h action line. An Apgar score of ≤6 at 1 min was an indicator for resuscitation. More than one-third of the low Apgar scores occurred during normal labour left to the alert line. Crossing the alert line yielded a relative risk (RR) for resuscitation of 1.91 (95% confidence interval, CI 1.44 – 2.52); p < 0.0001). Crossing the 4 h rather than the 3 h action line resulted in a RR for resuscitation of 1.41 (1.04 – 1.90) (p = 0.07). There is no clear indication suggesting that an action line set 1 h earlier would improve pregnancy outcome.