In the WHO modified partograph, the 'alert line' is drawn from 4 cm of cervical dilatation along a slope of 1 cm per hour. Where is the 'action line' placed?
- A Two hours to the right of the alert line
- B Four hours to the right of the alert line ✓
- C Six hours to the right of the alert line
- D It coincides with the alert line at full dilatation
Correct answer: B. Four hours to the right of the alert line
Explanation
In the WHO modified partograph the action line is plotted exactly four hours to the right of the alert line. Crossing the alert line signals the need for closer supervision and augmentation, while crossing the action line mandates intervention, usually referral or decision for operative delivery. Two-hour separation was never part of the WHO design, and the lines are parallel throughout labour, so they do not meet only at full dilatation.
Reference: Williams Obstetrics, 26th ed.
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