www.medenosrce.net/arhimed   arhimed(a-t>medenosrce.net   [25/04/2026 12:30:37] http://www.medenosrce.net/arhimed/poglej.asp?id=73 Oblika partograma in izid poroda Avtor: Urška Kogovšek Mentor: prof. dr. Živa Novak - Antolic, dr. med Somentor: Vladimira Assejev, dr. med Izhodišca. Odstotek carskih rezov raste. Vse vec je posegov v spontan potek poroda. Problem. Partogram poleg ostalih podatkov vsebuje graficni zapis odpiranja maternicnega ustja ter spušcanja in sukanja vodilnega plodovega dela v casu. Na Porodnem zapisniku, ki je v rabi v vseh porodnišnicah v Sloveniji, je razmerje enot med absciso (cas v urah) in ordinato (odpiranje maternicnega ustja v centimetrih) 4:1. Svetovna zdravstvena organizacija priporoca uporabo partograma z razmerjem enot osi 1:1, ker naj bi bile pri prvem, položnejšem diagramu, pogosteje agresivne. Namen raziskave je bil primerjati odlocitve porodnicarjev in babic o vodenju poroda ob uporabi partograma z razmerjem osi 4:1 in 1:1. Delovna hipoteza. Pri uporabi partograma, katerega razmerje med enotama na abscisi in ordinati je 4:1, so porodi daljši, veckrat se operativno dokoncajo, vec je poškodb porodnih poti in izid za novorojencka je slabši kot pri uporabi partograma z razmerjem enot osi 1:1. Metode. V randomizirano prospektivno raziskavo je bilo vkljucenih 2352 žensk z enoplodno nosecnostjo, ki so od 1. 10. 1998 do 31. 3. 1999 rodile v Klinicnem centru Ljubljana, Ginekološki kliniki, Porodnišnici Ljubljana, ob gestacijski starosti ploda 37 tednov 0 dni in vec. Opazovani izid poroda smo ovrednotili s statisticnima metodama multiple linearne in logisticne regresije. Rezultati. Analiza rezultatov je pokazala, da oblika partograma ne vpliva na trajanje poroda (p = 0,257), operativno dokoncanje poroda (p = 0,670), poškodbe porodne poti (p = 0,376) in oceno stanja novorojencka po Apgarjevi v prvi minuti po rojstvu (p = 0,858). Zakljucki. Na osnovi naše raziskave o vplivu oblike partograma na izid poroda lahko sklenemo, da razmerje enot abscisne in ordinatne osi ne vpliva na izid poroda. «» [Abstract / English version] Partogram presentation and the outcome of labour and delivery Author: Urška Kogovšek Mentor: prof. dr. Živa Novak - Antolic, dr. med Co-mentor: Vladimira Assejev, dr. med Background. In general the caesarean delivery rate has been increasing. The spontaneous course of labour and delivery has been ever more frequently interfered with. Problem. Among other data, partogram includes a graphical record of cervical dilatation, descent and rotation of the presenting fetal part. In the Labour and Delivery Record, used in all 14 maternity hospitals in Slovenia, the ratio between the abscissa (time in hours) and ordinate (cervical dilatation) is 4:1. The World Health Organisation recommends the use of the partogram with the ratio 1:1, since the decisions taken with the first, flatter graph, are supposed to be more aggressive. The aim of this study was to compare the decisions taken by the obstetrician and the midwife on the management of labour considering the two partograms, the partogram 4:1 vs. the partogram 1:1. Working hypothesis. The partogram 4:1 leads to longer labours, frequently ending in operative delivery, resulting in a higher rate of birth injuries and the neonatal outcome is inferior to that when partogram 1:1 is used. Methods. In this prospective randomised study we enrolled 2352 women with a singleton pregnancy at the gestational age of 37 weeks 0 day and over, who delivered at the University Medical Centre Ljubljana, Department of Obstetrics and Gynaecology, in the period from 1 October 1998 to 31 March 1999. The observed outcome of labour and delivery was statistically evaluated using the multiple linear regression and logistic regression methods. Results. The analysis showed no effect of the shape of the partogram on the duration of labour (p=0,257), on the operative delivery (p=0,670), on the birth injuries (p=0,376) and the 1-min Apgar score (p=0,858). Conclusions. On the bases of the obtained results we may conclude that the shape of the partogram does not affect the outcome of labour and delivery.