Which partogram criterion defines 'active phase arrest' according to the latest ACOG/NICHD redefined labour guidelines?
- A No cervical change for 4 hours with adequate contractions, or 6 hours without adequate contractions ✓
- B No cervical change for 2 hours with adequate contractions in active phase
- C Cervical dilatation less than 1 cm/hour for 4 consecutive hours
- D No cervical change for 1 hour after artificial rupture of membranes
Correct answer: A. No cervical change for 4 hours with adequate contractions, or 6 hours without adequate contractions
Explanation
The ACOG/NICHD (Zhang et al.) redefined labour guidelines 2014 define active phase arrest as no cervical change for ≥4 hours with adequate uterine contractions (≥200 Montevideo units), OR ≥6 hours without adequate contractions. This is more conservative than the older 2-hour Friedman criterion and allows more time for labour progress, significantly reducing the primary caesarean rate without compromising maternal-fetal outcomes.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.