The partogram: a missed opportunity.

To the Editor: The maternal mortality rate (MMR) in South Africa was 400/100 000 births in 20051 and at Johannesburg Hospital was 476/100 000 in 2008. Delay in referral and management during labour in the unit is an important cause of mortality and morbidity.2 Inadequate use of the partogram is a major avoidable factor in maternal deaths in South Africa and has previously been studied at Johannesburg Hospital.3,4 We did a retrospective record review of all partograms for 1 week (5 11 August 2008) in the labour ward at Johannesburg Hospital. The Committee for Ethics on Human Research at the University of the Witwatersrand approved the study.