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Question

During the first stage of labour, the intrauterine pressure is increased up to

The correct answer is
40-50 mm of Hg

Intrauterine Pressure During the First Stage of Labour

Intrauterine pressure (IUP) is generated by contraction of the myometrium and can be measured directly with an intrauterine pressure catheter (IUPC) or estimated using Montevideo units. It varies through the course of labour, being lowest in early labour and rising progressively as labour advances.

Analysing the Options

  • 40-50 mm of Hg (correct): During the first stage of established/active labour, uterine contractions generate intrauterine pressures in the range of 40-50 mm Hg above the resting baseline. This is the typical peak contraction pressure recorded with intrauterine pressure catheters during normal, effective labour.
  • 2-3 mm of Hg: This value is far too low for an active labour contraction; it approximates the very low baseline tone seen in a completely quiescent, non-labouring uterus, not the pressure generated during the first stage of labour.
  • 8-10 mm of Hg: This corresponds roughly to the uterine resting tone between contractions during labour, not the pressure achieved at the peak of a contraction.
  • 100-120 mm of Hg: This figure is too high for spontaneous labour contractions of the first stage; such pressures are not physiologically generated by normal uterine activity and do not correspond to standard labour physiology values.

Conclusion

During the first stage of labour, effective uterine contractions raise the intrauterine pressure up to 40-50 mm of Hg, which is essential for progressive cervical dilatation. This is distinct from the low resting tone (8-10 mm Hg) maintained between contractions.

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Important Questions from Normal Labour

  1. 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.

  2. According to the WHO Intrapartum Care Guidelines, 2018, the active phase of labour starts from what dilation of cervix?
  3. 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.

  4. The normal rate of dilatation of the cervix in a primigravida in the active phase of labor is
  5. Regarding the phenomenon of 'lightening' in primigravida at term pregnancy, which one of the following statements is correct?
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