The following graph represents the stages of labor. Which of the following statements is true about the graph C?
Secondary arrest after progression of labor
Prolonged active phase of labor
Prolonged latent phase/primary arrest of labor
Normal labor in a primigravida
Ans. is a, i.e. Secondary arrest after progression of laborNow friends--first you should know how to read this graph.If you see their is a horizontal line shown which corresponds to 3 cms, i.e. in this graph-active phase is beginning at 3 cms.In the graph line marked as 'mean'--means normal graph.In the graph marked as mean, the patient is reaching 3 cms at 8 hrs, i.e. latent phase ends at 8 hrs and active phase begins. Now in active phase minimum dilatation should be 1 cm/hr i.e. from 3 cms to 10 cms it should take maximum 7 hrs, i.e. 8+7=15 hrs. Now if you see the patient reached 10 cms (full dilatation) well within the time i.e. at 12 hrs.Now keeping this mind let's analyze:Graph AIn graph A--patient is reaching 3 cms i.e. active phase at 20 hrs or more, which means latent phase is prolonged.As prolonged latent phase in:Nulliparous = 20 hrsMultiparous = 14 hrsSo graph A shows prolonged latent phaseGraph BLatent phase (i.e. uptil 3 cms dilatation) occurred at 14 hrs. Then from 3 cms to 10 cms the patient is taking around 10 hours (14 to 24 hrs) whereas this 7 cms of dilation should have been completed in maximum 7 hours 1 cm/hr. This means here active phase is getting prolonged.Graph CThe latent phase ended at 8 hours. Then the patient dilated till 6 cms 10-11 hours.Now from 11 to 16 hours she is 6 cms dilated, i.e. 4 hours have passed and still there is no dilatation. Now since nothing has been mentioned about membranes, I am assuming they are ruptured.So it is a case of active phase arrest i.e. secondary arrest after progression of labor.
Normal Labour