According to ACOG (2014) guidelines on labor dystocia, active phase arrest (failure to progress) is defined as no cervical change after at least how many hours of adequate contractions in the active phase?
- A 4 hours ✓
- B 1 hour
- C 2 hours
- D 6 hours
Correct answer: A. 4 hours
Explanation
Per the 2014 ACOG and SMFM consensus statement, active phase arrest is defined as no cervical change after ≥6 hours with adequate contractions (≥200 Montevideo units) or after ≥4 hours with inadequate contractions despite oxytocin augmentation. The key update in 2014 was that active phase begins at 6 cm dilation (not 4 cm as previously taught), and failure to progress before 6 cm should not be used as indication for cesarean. The answer here refers to the 4-hour criterion with oxytocin-augmented adequate contractions.
Reference: Williams Obstetrics, 26th ed.
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Written and medically reviewed by the StethoPrep medical team.