Consider the following statements regarding the WHO Labour Care Guide for labour monitoring : 1. Active phase starts from 5 cm of cervical dilatation. 2. There is fixed rate for dilatation for every hour of labour in active phase. 3. There are no alert or action lines on the partograph. 4. There is a separate section for intensive monitoring for second stage of labour as well. Which of the statements given above are correct?
1, 3 and 4
The correct answer is 1, 3 and 4. The WHO Labour Care Guide (2020) replaced the old partograph after evidence that the Friedman curve overestimates normal progress. Statement 1 is correct: the active first stage now begins at 5 cm dilatation, not 4 cm, and full dilatation is usually reached within 12 hours in a primigravida. Statement 3 is correct: the rigid alert and action lines have been removed, replaced by dilatation-specific reference thresholds for the time spent at each centimetre. Statement 4 is correct: a dedicated second-stage monitoring section has been added, which the old partograph lacked.
Statement 2 is incorrect: the guide explicitly abandons the fixed 1 cm per hour expectation, because normal labour may progress more slowly, especially between 5 and 6 cm, and the old rule led to unnecessary augmentation and caesarean section. Every option containing statement 2 is therefore wrong.
Key point: Three changes to remember: active phase from 5 cm, no alert/action lines and no fixed 1 cm per hour, and a separate second-stage section.
Important Questions from Normal Labour
Which of the following features are correct regarding onset of true labour?
1. Regular uterine contractions
2. Progressive cervical dilation and effacement
3. Presence of show
4. Labour and delivery are synonymous
Select the answer using the code given below.
- According to the WHO Intrapartum Care Guidelines, 2018, the active phase of labour starts from what dilation of cervix?
Onset of labour is initiated by which of the following?
1. Uterine distension
2. Increased CRH and ACTH from foetal hypothalamic-pituitary- adrenal axis
3. Increased level of progesterone immediately before labour
4. Increased synthesis of myometrial receptors for oxytocin due to effect of oestrogen
Select the correct answer using the code given below.
- The normal rate of dilatation of the cervix in a primigravida in the active phase of labor is
- Regarding the phenomenon of 'lightening' in primigravida at term pregnancy, which one of the following statements is correct?
