Rate of cervical dilatation in primi during the active phase of labour is:
Ans. b (1 cm/hr). (Ref. Dutta Obst. 6th ed. p 131)DIAGNOSIS OF STAGE AND PHASE OF LABOURFALSE LABOUR/NOT IN LABOUR# Cervix not dilatedTRUE LABOUR:First stage (The first stage of labor is that portion leading up to complete dilatation)Latent# Cervix dilated 4-9 cm# Rate of dilatation typically 1 cm per hour or more# Fetal descent beginsActive# Cervix fully dilated (10 cm)# Fetal descent continues# No urge to pushSecond stageEarly (non-expulsive)# Cervix fully dilated (10 cm)# Presenting part of fetus reaches pelvic floor# Woman has the urge to pushLatent Phase# Taking up of cervix is determined by obliteration of projection of cervix into vagina.# The anterior lip of cervix is the last to be effaced.CERVICAL DILATATION# Cervical dilatation related with dilatation of external OS.# Cervical dilatation is expressed either in terms of fractions of full dilatation l/4th; 1/2 or 3/4th OR in terms of fingers - 2, 2, 3 or fully dilated; OR better in terms of cm (10 cm when fully dilated).# Taking up is expressed in terms of % fractions.One finger equals to 1.6 cm# Partogram (Freidman's Curve) is composite graphical record of OS dilatation and descent of head against duration of labour in hrs.# Dilatation of cervix at rate of lcm/hr in primi and 1.5 cm in multi, beyond 3cm dilatation is satisfactory.# In primi, latent phase is long (8hrs) and cervical dilatation occurs at 0.35 cm/hr.Stages of LaborStageStarts/EndsDurationCommentsFirst MrimiMultib LatentOnset of labor to 3-4 cm dilation6-11 hrs4-8 hrsProlongation seen with excessive sedation and hypertonic uterine contractions.Active4 cm to complete cervical dilation (10 cm)4-6 hrs(1.2 cm/hr)2-3 hrs(1.5 cm/hr)Prolongation seen with cephalopeivic disproportion.SecondComplete cervical dilation to0.5-3.0 hrs5-30 minBaby goes through all cardinal delivery of infant movements of labor.ThirdDelivery of infant to delivery0-0.5 hr0-0.5 hrPlacenta separates and uterus of placenta contracts to establish hemostasis. PROGRESS OF LABOR# For primi, labor usually lasts about 12-14 hours.# For multi, labor is generally quicker, lasting about 6-8 hours.# During labor, the cervix dilates (opens) and effaces (thins).# Labor should be progressive.# Serial vaginal examinations are used to plot the course of labor, detect abnormalities, and allow for intervention.# While there are no set time intervals for performing pelvic examinations, the cervix should progressively dilate during active phase labor at a rate of no less than 1.2 cm/hour (for first babies) to 1.5 cm/hour (for subsequent babies).
0.5 cm/hr
1 cm/hr
1.5 cm/hr
2 cm/hr.
Miscellaneous (Gynae)