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The cervicograph in labour management in the Highland of Papua New Guinea.

The use of the cervicograph with the incorporated action and alert lines in labour management in developing country obstetrics is now well established and patients in labour in Port Moresby have been thus managed since 1973. In this study the cerviograph was introduced in hospitals and health centres in Enga Province and the results analysed. Despite intensive tuition in its use, a large number of cervicographs were incorrectly constructed, especially in health centres, and its introduction made little difference to operative delivery or perinatal mortality rates. The proportion of patients crossing the action line was much higher than in Post Moresby but this difference was probably also largely due to the inaccuracy of many cervicographs. It is likely that these difficulties will not be overcome until many more nurses with intensive training in the use of the cervicograph are available and until more deliveries take place in health institutions to maintain practice. In the interim a simpler rule of thumb for referral of labour patients may be helpful.