Insomnia, Related Problems and Coping Strategies Among Primigravida and Multigravida Mothers

Background: Insomnia is a typical complaint during pregnancy. Hormonal alterations, physiological changes during early pregnancy, and the enlargement of the foetus during late pregnancy contribute to disrupted sleep. Nursing interventions to identify sleep deficits and promote sleep are required at all stages of the maternity cycle. Methods: Insomnia, related problems and coping strategies were assessed using a structured Questionnaire of purposive sample of 50 Primigravida and 50 Multigravida Mothers attending OBG unit at HSK hospital and research centre, Bagalkot, Karnataka. Data were analyzed using descriptive and inferential statistics. Results: The result depicts that the majority of primigravida mothers (92%) experienced moderate and 8% experienced severe insomnia, 94% moderate, 4% mild and 2% experienced severe insomnia-related problems, 84% followed average, 12% good and 4% followed poor coping strategies, whereas, majority of Multigravida mothers (90%) experienced mild and 10% experienced moderate insomnia, 82% moderate and 18% experienced mild degree insomnia related problems, 92% followed average, 6% good and 2% followed poor coping strategies. There is a significant difference between primigravida mothers' insomnia, related problems and coping strategies and that of multigravida mothers. There was an irrelevant association found between insomnia scores of Primigravida and Multigravida mothers with socio-demographic variables. Conclusion: The overall study findings depicted that the mean percentage scores of insomnia of primigravida mothers (49.33%) was comparatively higher than the mean percentage scores of multigravida mothers (16.33%). Hence it was concluded that primigravida mothers has experienced more insomnia than compared to multigravida mothers.

An Effective Management for Thalassaemic Patients during Pregnancy

Background : Presence of thalassaemia is considered high risk in pregnancy. The present study find out the role of antenatal and intrapartum care to improve the outcome of pregnancy in thalassaemia. Materials and Method : The prospective longitudinal study was carried out on 25 patients. CBC, LFT, Ferritin, Hb electrophoresis, serial USG was done. Chorionic villous sampling was offered to thalassaemic women to decrease the number of babies born with Thalassaemia. Furthermore, management and treatment options provided to mother to overcome the incidence of maternal and neonatal complications during current pregnancy. Results : 44% of thalassaemic pregnant women had HbE ? thalassaemia, 8% ? thalassaemia major and others had thalassaemia carriers, while only 20% of their partners showed ? thalassaemia trait. All patients were anemic and during delivery mean Hb% were 8.42 g/dl, MCH 22.09 pg, MCV 73.56 fl, MCHC 29.86 g/dl and ferritin 241.51 ng/ ml. Third trimester USG exhibited 32% developed IUGR (Intrauterine growth restriction). 40% patients received blood transfusion after delivery. ? thalassaemia trait was identified in 20% babies at 6 month. Conclusion : Postpartum haemorrhage is a major complication of thalassaemia in pregnancy. After delivery a thorough neonatal check-up and haematological work-up is important for prevention of neonatal mortality and early detection of thalassaemia.

PERINEOTOMY CARE AFTER CHILDBIRTH

Every woman who became pregnant has to undergo the process of delivery. In normal process of delivery the baby is delivered per vagina, an episiotomy is performed by health care provider or midwife. Episiotomy is a surgically planned incision on the perineum and the posterior vaginal wall during the second stage of labour to enlarge the vaginal introits so as to facilitate easy and safe delivery of the fetus. Episiotomy may be advice in the situations such as inelastic perineum, fetal distress, and complicated birth, prolonged second stage of labor, instrumental vaginal delivery and previous perineal surgeries .There are four types of episiotomy: midline, mediolateral, lateral and J shaped. Care of episiotomy involves perineal care, sitz bath, infrared heat, perineal exercises, antiseptic ointments, cold and hot packs The REEDA scale is used for assessing the perineal healing. Complications of episiotomy include perineal discomfort, perineal pain, difficulty with breast feeding and walking, perineal bleeding, infection, wound dehiscence and dyspareunia

Prevalence of Anxiety Among Antenatal Women in An Urban Area of Belagavi

Background: A woman is highly vulnerable to anxiety and stress during her pregnancy causing negative effect in somatic and psychological forms like Intrauterine growth restriction, low birth weight and pre-term birth in child. Maternal anxiety not only leads to adverse effect on pregnancy outcome but also de-creases maternal competence in childcare. Aims/Objectives: Determine the prevalence of antenatal anxiety among women attending Ashok Nagar UHC and identify the associated risk factors. Methodology: A cross sectional study was done for 3 months in 320 antenatal women attending antena-tal clinic at Ashok Nagar UHC. Data collection was done using a pre designed and pre tested question-naire. Results: Theprevalence of antenatal anxiety was 31.2%. Among them 30% had mild to moderate anxie-ty and only 1.2% had severe anxiety. Prevalence of anxiety was higher in younger women and with low-er literacy status. Conclusion: Antenatal anxiety is of major public health importance but its effect on mother is not con-sidered to be a serious issue in the society. There is a need for regular antenatal screening, assessment and treatment of antenatal anxiety.

A STUDY ON FETO-MATERNAL OUTCOME IN A POSTDATED PREGNANCY

BACKGROUND: The objective of the study is to find out the fetal and maternal complications in post dated pregnancy. This is a prospective observational study. METHODS: Patients who have completed 40weeks of gestational age, meeting the inclusion criteria. RESULTS: Of 100 cases 74(74%) cases were under 20 to 25 years, majority cases were primigravida (66%), overall caesarean rate was 36%, Meconium-stained liquor with fetal distress was the most common indication for LSCS 9(25 %). Fetal distress was the most common fetal complications, number of induced labor is 71.4% at 41 weeks 1 day to 42 weeks CONCLUSION: In our study we concluded that prolonged pregnancy was associated with significant risk of perinatal complications like fetal distress, meconium aspiration syndrome and IUGR. There was significantly increased risk of obstetric complications like oligohydramnios, perineal tear, atonic PPH and shoulder dystocia.

The role of prophylactic aspirin intake in reducing the risk of development of preeclampsia among nonhigh-risk primigravidas in two tertiary hospitals in Dasmariñas and Imus, Cavite: A retrospective cohort study / Philippine Journal of Obstetrics and Gynecology

Background@#Pre-eclampsia is a multi-organ progressive disorder that is estimated to complicate 2 to 8% of pregnancies. Numerous studies on prophylactic aspirin intake among high-risk pregnant women has been established but studies involving low-risk primigravida women are limited.@*Objectives@#To determine if prophylactic intake of aspirin will reduce the occurrence of preeclampsia among primigravida women with no identified comorbidities and to determine the incidence and association of identified secondary outcomes.@*Methodology@#This retrospective cohort study was conducted from January 2018 to December 2020 in two (2) tertiary hospitals in the province of Cavite. Two hundred four (204) primigravida women with no identified co-morbidities and delivered to a singleton fetus, vaginally or operatively, were identified and included. In-patient and out-patient charts of primigravida women, with aspirin intake versus no aspirin intake, were reviewed. Primary outcome (pregnancy induced hypertension) and secondary outcomes (preterm delivery, small-for-gestational age infants, IUFD, HELLP syndrome and abruption placenta) were identified.@*Results@#The mean age of patients was 27.1 years and 25.9 years in the aspirin and non-aspirin group, respectively. In aspirin group, 4.9% of the patients developed pre-eclampsia versus 9.8% in non-aspirin group showing statistical significance. The effect of aspirin across other hypertensive disorders of pregnancy were noted to be the same. However, influence of aspirin with the average blood pressure on admission and secondary outcomes were not statistically significant.@*Conclusion@#CONCLUSION: Prophylactic aspirin intake has a significant effect in preventing pre-eclampsia among non-high risk primigravida women but did not influence the average blood pressure on admission, development of preterm PIH, and development of the secondary outcomes.

A clinical study of primary caesarean section at a tertiary care hospital in coastal city: an observational study

Background: Caesarean section represents the most significant operative intervention in obstetrics and its development and application has saved the lives of countless mothers and infants. However there has been a steady increase in the rate of caesarean sections worldwide. In this study, we aim to find the primary caesarean section rates and strategies to cut it down.Methods: This was a prospective observational study done from January 2018 to June 2019 at Justice K. S. Hegde Charitable Hospital, Deralakatte, Mangaluru which included 379 cases of primary cesarean sections. All patients undergoing primary caesarean section with gestational age >28 weeks confirmed by dates, clinical examination and ultrasound were included in this study. Patients who had undergone previous caesarean section or were less than 18 years of age or were less than 28 weeks of gestation were excluded from the study.Results: In this study the rate of primary caesarean section was found to be 14.5% and the majority of the study subjects belonged to the age group of 18-27 years (62.3%). With respect to parity, primigravida were high in number (71.2%), followed by multigravida. The number of emergency caesarean sections were (79%) more than elective (21%). The most common intra-operative complication was post-partum haemorrhage (PPH) in 2.8% and the most common postoperative complication was wound gape in 2.1%.Conclusions: Maximum efforts should be made to allow progression of vaginal delivery in primigravida which helps us to bring down the primary caesarean rate.

A prospective study of safety, efficacy and acceptability of postpartum insertion of intrauterine contraceptive device in a tertiary care hospital in Maharashtra, India

Background: IUCD (intrauterine contraceptive device) to prevent pregnancy are among the oldest method of contraception. The modern IUCD are highly effective, safe private, long acting and rapidly reversible contraceptive method. Aims and objective of this study was to study the acceptability and safety of postpartum intrauterine contraceptive device (PPIUCD) in postpartum period and to assess the feasibility, safety, efficacy and expulsion rate of IUCD.Methods: A prospective observational study was conducted at tertiary care teaching hospital in Maharashtra from January 2018 to October 2018 and patients were followed up to a period of one-year post IUCD insertion.Results: Majority of patients in this study were in age group 21 to 26 years of age (58.7%) and the least number were in the age group more than 30 years (3.3%). This study showed that majority of patients were primigravida (44%) and the lowest number belonged to gravida 6 (0.3%). Regarding timing of IUCD insertion 73% were done intra caesarean, 22.3% were done post placental and 4.7% were done within 48 hours of delivery. In this study authors found that 4% of patients had per vaginal discharge, 5% had missing IUCD thread and 2% of patients had IUCD expulsion. It was found in this study that 98% of patients continued to use IUCD and only 2% discontinued the usage.Conclusions: From the study authors came to conclusion that PPIUCD insertion is a safe, feasible, effective and reversible method of contraception.

Successful reduction of acute puerperal uterine inversion with use of Bakri postpartum balloon

Acute puerperal inversion is rare but potentially fatal obstetric emergency and prompt recognition will enable immediate repositioning of uterus before it becomes edematous and incarcerated. Manual repositioning along with use of uterine balloon tamponade is simple and effective way for repositioning of inverted uterus as well as prevention of recurrence.

Study of socio-demographic factors in cases of pregnancy induced hypertension and its associated risk factors in a tertiary care hospital

Background: The aim of the study was to study the socio-demographic factors in cases of pregnancy induced hypertension and its associated risk factors in a tertiary care hospital.Methods: The present retrospective study was conducted in the obstetrics and gynecology department of Shrimati Heera Kunwar Baa Memorial Hospital, Jhalawar, Rajasthan from December 2018 to November 2019. A total of 80 cases of pregnant women with PIH were studied. The socio-demographic data like age, parity, gestational age of presentation, mode of delivery, maternal and perinatal complications were noted from the hospital records and studied.Results: The incidence of PIH was found to be 8.16% in pregnant women attending the SHKBM Hospital. Majority of the study subjects were rural dweller (70%). A higher incidence of PIH was found among illiterate women (51.25%). 53.75% cases were in the age group of 25-30 years and 25% were in the age group of 19-24 years. In the present study, incidence of PIH was found to be highest among primigravidas (67.50%) as compared to multigravidas (32.5%). Most cases were delivered by caesarean section (73.75%) and 26.25% were delivered vaginally. Out of 80 cases, 16.25% of cases were complicated by eclampsia, Severe PIH in 12.5%, abruptio placentae in 2.5% and HELLP Syndrome in 1.25% cases.Conclusions: PIH is a very common complication encountered in pregnancy associated with adverse maternal and fetal outcome. The risk is higher among young primigravidas and in rural population. Better health care facilities and awareness among the pregnant women will help in reducing the incidence of PIH and its associated complications.

Cervical effacement, as an independent parameter versus modified bishop score, for predicting the favorability of vaginal delivery in a primigravida at 40 weeks gestation and beyond

Background: Dr. Edward Bishop developed the original bishop score. He concluded that elective induction in multiparous women was successful with a score > 8. Calder introduced the modified bishop score in which he replaced cervical effacement with cervical length in cms. Score of 6-12 is favourable. In this study, studied the cervical effacement/ length as an independent predictor of vaginal delivery in a primigravida.Methods: A retrospective observational study was conducted from May 2018 to January 2019. Total participants were divided into two groups on the basis of spontaneous labor and induced labor. Both the groups were assessed individually and collectively in terms of cervical effacement/length and modified bishop score. Study primary outcome was vaginal delivery. The results were reflected in terms of sensitivity, specificity, PPV and NPV. These values were compared for cervical effacement/ length as well as modified bishop score and p value calculated. Also, association between modified bishop score and cervical effacement/length was established.Results: Total number of participants included was n = 91. Those with modified bishop score > 6, 78.16% had vaginal delivery. This gave a sensitivity of 78.16%, specificity of 50%, PPV of 97.14%. Those with cervical effacement of >/=50% or cervical length of </= 2 cms, 78.82% had vaginal delivery. This gave a sensitivity of 78.82%, specificity of 55%, PPV of 95.71%. Thus, it had similar sensitivity, specificity, PPV to that of modified bishop score, and therefore has the same accuracy in predicting vaginal delivery. Also, 89.01% participants who had cervical effacement >/= 50% had modified bishop score >/= 6, reflecting the association between them.Conclusions: Cervical effacement of >/= 50% or cervical length </= 2 cms yielded an equivalently high predictive ability similar to modified bishop score, for spontaneous as well as induced labor. Hence, cervical effacement can be taken as an independent parameter to assess the favorability of successful vaginal delivery in a primigravida.

Pregnancy outcome in elderly primigravida

Background: Incidence of elderly primigravida has increased now days, due to rising education level, effective means of birth control and high carrier goals. The women who conceived in advanced age more than 35 years for first time is defined as elderly primigravida. Indian standard is fixed at more than 30 years by Dutta 2013. These women are high risk for maternal and foetal complication and outcome. The study was done to assess pregnancy outcome in elderly primigravida.Methods: This is a prospective hospital-based study done from October 2016 to November 2018. Women of reproductive age group with first pregnancy admitted to department of obstetrics and gynaecology, Veer Surendra Sai Institute of Medical Science and Research, Burla were taken after exclusion criteria.Results: The incidence of elderly primigravida was 2.51%. But majority (84.76%) though married early, conceived late. Most of them are belongs to high socioeconomic group (62.86%). Anaemia was commonest complication (28.57%), fibroid in 5.71% cases. Pre-eclampsia (18.09%), eclampsia (3.81%), IUGR (12.38%) and twin pregnancies (5.72%) were seen more frequently than young primigravida. 55.24% were developed complications during labour like foetal distress (33.33%), PPH (3.81%) and retained placenta (2.86%). Gestational diabetes mellitus in (0.95%), caesarean section rate 29.52%, normal delivery 51.42%, and congenital anomaly 8.15%.Conclusions: Elderly primigravida are high-risk for several complications like spontaneous abortion, preterm labour, prolonged labour, foetal distress, high caesarean rate, PPH, congenital anomaly and increased incidence of perinatal mortality. Majority of this patients properly supervised are capable of safe and successful pregnancies ending in healthy mother and healthy baby.

A comparative study of efficacy and safety of intramuscular carboprost and intravaginal misoprostol for cervical priming prior to first trimester surgical abortion

Background: MTP Act no 34 of 1971 has been defined as Legal termination of pregnancy before the age of viability of fetus that is 20 weeks of gestation. There is a need to find a medical agent which can help in the process of abortion by speeding it up, with minimal side effects. The objective of this study was to compare the efficacy of I.M carboprost and intravaginal Misoprostol and to evaluate the safety profile of I.M carboprost and Intravaginal Misoprostol. To compare the cervical dilatation caused by I.M carboprost and intravaginal Misoprostol and to compare the blood loss and adverse effects of I.M carboprost and Intravaginal Misoprostol.Methods: Prospective randomized experimental study including pregnant women up to 12 weeks of gestation opting for M.T.P. Study conducted on 200 patients selected from patients admitted in MGM Medical College and M.Y. Hospital, Indore and Kalyanmal Hospital, Indore during the period July 2014 to March 2015. They were randomly divided into 2 groups. Group A who received intramuscular injection of 250 mcg of caboprost or Group B,which received 400 mcg of vaginal Misoprostol 4 hours prior to suction evacuation.Results: Intravaginal misoprostol achieves better cervical dilatation compared I.M carboprost which is statistically significant. Misoprostol is associated with higher blood loss as compared to I.M carboprost which is associated with nausea/vomiting & more likelihood of loose stools and abdominal cramps which is proved statistically.Conclusions: Intravaginal misoprostol is associated with higher blood loss as compared to I.M carboprost which is significant but intravaginal misoprostol achieves more cervical dilatation and causes less adverse events than I.M carboprost which is statistically more significant and therefore intravaginal misoprostol is the drug of choice for cervical priming prior to surgical abortion in terms of both efficacy and safety.

Knowledge, attitude and practices about exclusive breastfeeding among antenatal women

Background: Breastmilk is considered as one of the healthiest, nutrition-rich yet least expensive method of infant feeding. It is a universally accepted fact that breastmilk meets all the nutritional demands of the new-born. There are extensive benefits of breastfeeding for the new-born as well as for the nursing mother which have been documented from time to time.Methods: A multiple-choice questionnaire was used to interview the participants during data collection.Results: Using the IBM SPSS version 20 software, descriptive analysis of the categorical variables has been presented using frequency and percentage tables. Regarding the practices about breast feeding in primigravidas, their concepts about the same have been captured in this study.Conclusions: Though the knowledge about exclusive breast feeding was not extraordinary among the participants, they had a very favourable attitude towards the same. Almost all patients were also extremely receptive and inquisitive during the session for discussion about the same.

A study of homocysteine level at the III trimester of pregnancy

Background: Homocysteine is an amino acid which has sprung into prominence in the past few decades. Levels of maternal serum homocysteine normally decreases with gestation, either due to a physiological response to the pregnancy, increase in estrogen, haemodilution from increased plasma volume or increased demand for methionine by both the mother and fetus.Methods: A prospective randomized controlled clinical trial of 50 patients was carried out in Kamla Raja Hospital and outpatient Department of Gajra Raja Medical College, Gwalior from October 6th to October 2007, which was further categorized into socio-demographic and clinical factors.Results: Out of 50 patients, it was found that there were 31(62%) cases below the age of 25 years whereas 19(38%) cases were above the age of 25 years, 30(60%) cases were educated below the primary level whereas 20(40%) cases were educated above the primary level, 10(20%) cases belonged to rural areas whereas 40(80%) cases belonged to the urban areas. According to the socio economic distribution, 11(22%) cases were below class II whereas 39(78%) cases were above class II. According to distribution of parity, 22(44%) cases were below primigravida whereas 28(56%) cases were above primigravida.Conclusions: This study concludes that mean of Serum Levels in pregnant women with socio-demographic and clinical factors was statistically insignificant which signifies that age, education, residential areas and hemoglobin are not the factors contributing to the rise in homocysteine level in pregnant women. The diastolic and systolic blood pressure is weakly correlated with serum homocysteine level.

Prevalence of Chlamydia pneumoniae seropositivity in early pregnancy and its association with preeclampsia among primigravidae in Indian population

Background: Preeclampsia (PE) is a multifactorial disease that might be caused by a concurrent or preceding inflammatory stimulus. Inflammatory changes similar to those reported in chronic Chlamydia pneumoniae infection are seen in PE. It is suggested that persistent or chronic Chlamydia pneumoniae infection might have a role in the pathogenesis of PE and antichlamydial treatment in early pregnancy may prevent reactivation of infection and hence the development of preeclampsia.Methods: This randomized interventional study was conducted to determine the prevalence of C.pneumoniae IgG seropositivity in early pregnancy, its association with PE and the effect of treatment with oral azithromycin. A total of 330 primigravidae included in the study were followed up till delivery. C.pneumoniae IgG antibodies measured by ELISA technique at 14-20 weeks of gestation revealed seropositivity in 32.4%. These women were at higher risk of developing severe PE (odds’ ratio 3.2) as compared to the C. pneumoniae seronegative cases.Results: Treatment with oral azithromycin resulted in reduction in the occurrence of PE amongst the C.pneumoniae seropositive cases; as well as significant reduction in the incidence of low birth weight babies in the C.pneumonie seropositive group (p<0.001, ARR= 0.204).Conclusions: Pregnant women who were C.pneumonia IgG seropositive are at higher risk of developing severe preeclmapsia as compared to the C.pneumoniae seronegative cases. This association needs to be further evaluated.

Maternal outcome of primigravida patient with term pregnancy with engaged versus unengaged foetal head at onset of labour

Background: The primigravida are a group at risk as their capacity of child bearing has never put to the test, “primigravida is a dark and untired horse". The potential for future child bearing is determined by outcome of first labour. Hence, if first pregnancy results in normal healthy child, patient is mentally better prepared for subsequent pregnancies. Foetal head is said to be engaged when its biparietal diameter, the greatest diameter in an occiput presentation, passes through the pelvic inlet. Unengagement of head in primigravida has long been considered a possible sign of cephalopelvic disproportion.Methods: The study had 220 primigravida of which 110 had unengaged head as study group and 110 engaged head as controls. Data collection was done and the course of labour in all the patients recorded on partograph and all the patients were studied in detail. Engagement of the head was defined on the basis of Second Pawlik’s grip and Crichton’s fifth’s formula.Results: Our study shows that higher age group had more number of cases with unengaged head. The patient with engaged head had higher number of vaginal delivery than study group with unengaged head. More number of LSCS i.e. about 39.1% in study group as compared to 21% of controls is statistically significant difference (p value 0.05).Conclusions: We can conclude that primigravida with unengaged foetal head at onset of labour may deliver vaginally with minimal maternal morbidity, if proper   monitoring and maintenance of partogram is done.

A comparative and correlative study of serum homocysteine level in gestational diabetes mellitus and normal pregnancy

Background: An alarming increase in Gestational diabetes mellitus (GDM) cases worldwide elevates concern regarding the consequences including fetal macrosomia, preeclampsia and many more. Plasma homocysteine levels which has direct impact on to endothelial function of blood vessels. The relationship of homocysteine and GDM is yet to be clarified.Methods: This single centre prospective observational study was conducted in Department of Obstetrics and Gynaecology of Thanjavur medical college hospital among 50 pregnant primi and multi gravida patients with normal pregnancy and gestational diabetes mellitus to assess the association and comparison of serum homocysteine levels in both groups.Results: The mean value of homocysteine in control group was 3.8 ± 0.95 and in gestational diabetes patients was 16.30±6.09. On comparison, found that there was hyperhomocysteinemia among GDM patients with normal pregnancy and results were statistically significant (T= -9.024 Df=48.000 <0.05).Conclusions: In this comparative and correlative study, we found that patients with gestational diabetes mellitus have higher serum homocysteine levels in comparison with normal pregnant women. Hyperhomocysteinemia is found to be an independent risk factor for gestational diabetes mellitus patients. Further investigations are needed to follow up for these patients in the postpartum period and later in their life.

Antimicrobial Usage Pattern in Uncomplicated Caesarean Section Delivery in a Tertiary care hospital of rural Bengal

Antimicrobials are very frequently used medications in Obstetrics and Gynaecology in there wide range of operative procedures and in treating various infections. Administering antimicrobial prophylaxis is a standard practice in caesarean section which is given in pre, intra and postoperative peroids. The present study was aimed to explore the antibiotic usage pattern in caesarean section in Bankura Sammilani Medical College , Bankura. Methods: A prospective observational study was conducted in the Department of Gynaecology and Obstetrics (G&O) in collaboration with the Department of Pharmacology of the Bankura Sammilani Medical College, Bankura. The study was carried out for a period of two months from February to March 2019. Results: Among 364 cases mostly were primigravida, commonest prescribed antibiotic being ceftriaxone parenteral followed by cefuroxime by oral route. Conclusion: Appropriate dose with proper duration of antimicrobial therapy in both elective and emergency Caesarean Section reduces the infective complication of mother and the new born.

Evaluation of partogram in 100 cases of both primi and multi gravida each, their outcome in labour and perinatal outcome

Background: the objective of this study was to study the utility of partogram in both primi and multi gravida and evaluate its role in preventing prolonged labour; assess the rate of cervical dilatation on admission, and to evaluate the maternal and perinatal outcome by comparing their partogram in labour.Methods: This observational prospective clinical study involved randomly selected 200 patients in labor divided into 2 groups of 100 each admitted in Khaja Banda Nawaz Institute of Medical Sciences, Gulbarga. Modified WHO partogram was used. Statistical analysis done by Chi square test.Results: Mean age group in primi was 22.05 years with standard deviation of 2.38 years and in multi mean age group was 25.19 years with standard deviation of 3.09 years. Mean duration of active phase of labor in primi was 2 hrs 12 mins and in multi was 1 hours and 35 mins from time of admission into hospital. Mean duration of second stage of labor in primi was 57 mins and in multi was 35 mins. Out of 100 primi gravida 68% had NVD, 1% had outlet forceps. 13% had vacuum application and 18% underwent LSCS. Out of 100 multigravida 86% had NVD, 1% had outlet forceps, 7% had vacuum application and 6% underwent LSCS. In group A in primi 75% had NVD, 0% had forceps, 5% had vacuum application and 0% LSCS whereas in multi 93% had NVD and 7% had vaccum, NO forceps /LSCS. In group B, in primi 20% had NVD, 4% had forceps, 33% had vacuum application and 43% had LSCS whereas in multi 34% had NVD, 8% had forceps, 8% had vacuum application and 50% LSCS. In group C, in primi 100% had LSCS whereas in multi there were no NVD/Vaccum/ forceps/ LSCS cases. In primi 100% and in multi 96% had no maternal complications. In primi 96% and in multi 97% had no neonatal complications.Conclusions: The partogram is used to assess the labor progress and identify when intervention is necessary. This study showed that it can be highly effective in reducing complications from prolonged labor for both mother & neonate, in reducing operative intervention and improving their outcome.