TITLE:
Documentation and Maintenance of the Partogram in a Professorial Obstetric Unit: A Clinical Audit with Pre- and Post-Intervention Comparison
AUTHORS:
Tharunya Rajayohan, Chandana Jayasundara
KEYWORDS:
Partogram, Intrapartum Care, Clinical Audit, Labour Monitoring, Documentation Quality
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.16 No.7,
July
23,
2026
ABSTRACT: Background: The partogram is the cornerstone of intrapartum monitoring, providing a real-time graphical record of labour progress, foetal wellbeing, and maternal condition. Despite its established role in preventing obstructed labour and foetal distress, audits globally and within Sri Lanka consistently identify gaps in its maintenance, compromising clinical decision-making and delaying timely intervention. Objectives: To assess the completeness of partogram documentation in a professorial obstetric unit; to implement targeted quality-improvement interventions; and to evaluate their impact through re-audit. Methods: A clinical audit with a pre- and post-intervention design was conducted at the Professorial Obstetric Unit, De Soysa Hospital for Women, Colombo. One hundred bed-head tickets from patients who were in labour were reviewed retrospectively (pre-intervention). Following a multi-component intervention—comprising a staff educational session, introduction of a vaginal examination rubber stamp, and random partogram checks with feedback—a further 100 records were reviewed three months later. All components were assessed against nationally and internationally accepted standards. Results: Pre-intervention, basic patient information, maternal vital signs, foetal heart rate, and cervical dilatation were generally well-documented. However, critical labour progress parameters, including abdominal descent (27%), foetal position (34%), caput (26%), and moulding (14%) were poorly recorded. Post-intervention, substantial improvements were observed across all deficient domains: caput (49%, p Conclusion: Targeted educational intervention and a structured vaginal examination stamp produced meaningful improvements across almost all partogram domains. Several components remain below optimal thresholds. Because the intervention was delivered as a single bundle, the observed improvement cannot be attributed with certainty to any one component in isolation. Regular re-audit, refresher training, and senior review are recommended to sustain these gains.