A primigravida in spontaneous labour at term has her progress plotted on the WHO partograph. Her cervical dilation curve reaches and then falls to the RIGHT of the action line. What does this signify, and what action is indicated?

• A Normal progress, continue expectant observation with partographic reassessment in 4 hours
• B Labour is progressing faster than expected, prepare for imminent delivery
• C Latent phase prolongation requiring therapeutic rest and sedation
• D Prolonged labour requiring intervention such as amniotomy and oxytocin augmentation ✓

Explanation

On the WHO partograph the alert line starts at 4 cm dilation and the action line lies 4 hours to its right. Crossing the action line means labour has become prolonged beyond the acceptable limit and demands active intervention, typically amniotomy plus oxytocin augmentation after reassessment of maternal and fetal condition and exclusion of cephalopelvic disproportion. Staying between the lines warrants observation alone, which makes option A the tempting but incorrect distractor.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.