A few years ago we discovered the VE was not being recorded on the partogram in any systematic way at the 7 maternity units in Northern Sydney to which I was attached- there was no record of every aspect of the VE- just cervical dilatation and no record of position of presenting part - and no decision making recorded in relation to the VE - so we invented a template (in the form of a stamp) added to the partogram that required the midwife or doctor to record all aspects of assessment of progress in labour with cervical dilatation being only one - it also required an abdominal palpation to be done and recorded- then required a decision to be made in relation to the findings. We followed up the implementation with an audit and found the midwives complied around 70% of the time- the doctors around 10% of the time so followed up with further education on the importance of the VE in relation to making decisions - an ongoing challenge.
regards Maralyn
Maralyn Foureur
Professor of Midwifery
Centre for Midwifery, Child and Family Health
Faculty of Nursing, Midwifery and Health
Phone: +61 2 9514 4914
Mobile: 0448448735
Email: [log in to unmask]
Level 7, Building 10, City Campus
PO Box 123 Broadway NSW 2007
Top ranked in NSW for nursing and midwifery research (ERA 4)
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Sent: Tuesday, 2 August 2011 5:34 PM
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Subject: query about the use of vaginal examination in labour and/or the use of the partogramme
Dear all
We are completing a protocol for a review on the value of the vaginal examination as a measure of progress in labour. We have been advised that the VE is never used without the partogramme (and without attention to all the elements on the partogramme). From our clinical experience, we are not sure that this is the case - we have practical experience of the VE being used as a measure of progress in labour without reference to the partogramme (even where it is part of the routine recording process) but our experience may well be very limited. We would be very interested in your experience in the following areas:
1. In your experience, is vaginal examination ever used on its own, without using a partogramme?
2. Where the partogramme is used as a record, are all the elements of it usually used in a decision on whether to intervene?
Many thanks for your advice
All the best
Soo
UTS CRICOS Provider Code: 00099F
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