Utilization of Partograph and its associated factors among midwives working in public health institutions, Addis Ababa City Administration,Ethiopia,2017.

BACKGROUND: Partograph is cost effective and affordable tool designed to provide a continuous pictorial overview and labour progress used to prevent prolonged and obstructed labour. It consists of key information about progress of labour, fetal condition and maternal condition. Its role is to improve outcomes and predict the progress of labour. The aim of this study was to assess utilization of partograph and its predictors among midwives working in public health facilities, Addis Ababa city administration, Ethiopia, 2017. METHODS: An institution based cross-sectional study design was conducted in Addis Ababa, Ethiopia from 15/10/2017-15/12/2017.Simple random sampling under multistage sampling technique was applied to select a total of 605 midwives working in maternity unit of selected public health facilities. Data were collected using structured self-administered questionnaire. Checklist based direct observations were made to all midwife participants to determine the actual practical use of partograph. Data first entered in to EpiInfo version 3.5.1 and transported to SPSS Version 21.Descriptive statistics such as frequency, percentage, mean, and median were calculated. Biviriate and multivariable logistic regression analysis were applied. Any personal identification of the study participants was not recorded during data collection to ensure confidentiality of information. RESULTS: In this study, the utilization of partograph was 409(69%) out of 594 study participants. Being mentored(AOR = 3.1; 95% CI: 1.7, 5.3),received training (AOR = 2.4; 95% CI:1.5,3.6),being knowledgeable about partograph (AOR = 1.6; 95% CI: 1.1, 2.5), health center workers(AOR = 12.6; 95% CI:5.1,31.6),supportive supervision 4 times per year (AOR = 18.6; 95% CI: 6.6,25),supportive supervision twice per a year (AOR = 4.7; 95% CI: 1.9, 11.3),supportive supervision once per year (AOR =3.8;95% CI:1.7,8.8) were positive predictors of partograph utilization. Two midwives per shift (AOR = 0.101; 95% CI: 0.05, 0.65), and 4 per shift (AOR = 0.105, 95% CI: 0.03, 0.40) were protective predictors of partograph utilization. CONCLUSIONS: More than half of the respondents utilized partograph. All public health institutions avail partograph in their laboring room but didn't utilize it according to WHO recommended standard. Working facility, supportive supervision, mentoring, training on partograph, number of midwives working per shift, and knowledge were factors affecting partograph utilization. Encouraging interventions are recommended to the response of the above significantly associated factors.

Waterproofing EMG Instrumentation.

While still experimental, measurement of external uterine electromyographic (EMG) activity is a more sensitive and noninvasive method for measuring uterine contractility in human labor than the methods currently used in clinical practice. Hydrotherapy is purported to improve contractility in labor, yet there have been no reports of abdominal uterine EMG activity measured during immersion. To test telemetric EMG equipment and different waterproofing techniques under dry and immersed conditions, the authors recorded surface EMG activity from the abdominal muscles of 11 healthy, nonpregnant women, 22 to 51 years of age. After attaching one pair of electrodes to the skin on either side of the umbilicus and applying the waterproofing material, the authors tested the signal by asking participants to perform a short series of leg lifts while seated in a chair to evoke abdominal muscle contractions. They were then immersed to the chest in a hydrotherapy tub while performing two to three leg lifts over 60 s every 5 min for 60 min with 20 lb of weight suspended from their ankles to counteract the buoyancy effect of water. EMG activity was continuously recorded. They then repeated the dry-measures sequence. While waterproofing remained intact, EMG signals were essentially unchanged between dry and wet conditions. Of the 11 waterproofing applications tested, 10 failed at some point. In the data from the successful application, EMG signals in both channels exhibited stable baselines throughout and an absence of low-frequency artifact. The development of this technique allows for the recording of external uterine EMG activity during hydrotherapy. The authors have begun using it to investigate the effects of hydrotherapy on uterine contractility during human labor.