During active labour, partogram shows the cervix has been at 7 cm for 3 hours despite adequate uterine contractions (> 200 Montevideo units). The head is at station 0, occiput is in the transverse position, and pelvis is adequate. The most likely diagnosis is:

• A Latent phase prolongation
• B Secondary arrest of active phase (active phase arrest) ✓
• C Failure of descent
• D Precipitate labour

Explanation

Secondary arrest (active phase arrest) is defined as cessation of cervical progress for ≥ 4 hours with adequate contractions (> 200 MVUs) or ≥ 6 hours with inadequate contractions in the active phase. After 3 hours here the diagnosis is becoming arrest; by ACOG criteria, caesarean is not indicated until 4 hours of arrest with adequate contractions. Failure of descent refers to arrest of fetal descent (station), not dilation. Latent phase prolongation occurs before 6 cm.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.