Question

A primigravida at 37 weeks of gestation presents with a 1 cm dilated, uneffaced cervix and uterine contractions with pain suggestive of labour for the last 10 hours. What is the management?

• A. Sedate the patient and wait
• B. LSCS
• C. Amniotomy
• D. Induction with membrane rupture

Hint:

No cervical progress after 10 hours means false labour, so reassure and observe.

Answer 1

The Correct Option is A

Step 1: Interpret the cervical findings. After 10 hours of painful contractions the cervix is only 1 cm dilated and remains uneffaced. True labour produces progressive cervical effacement and dilatation; the lack of any progress here points to false labour, not established (active) labour.
Step 2: Confirm she is in the latent phase or false labour. A closed or barely dilated, uneffaced cervix despite contractions is the hallmark of false labour or a very early latent phase. There is no indication for delivery on these findings.
Step 3: Eliminate operative and active intervention. LSCS has no indication in a term primigravida with a normal fetus and no labour progress problem, malpresentation or distress. Amniotomy and induction with membrane rupture are interventions to augment or start active labour and are inappropriate when the patient is not yet in established labour and there is no maternal or fetal indication to deliver.
Step 4: Choose conservative management. The correct step in false labour or early latent phase is reassurance, analgesia and sedation, allowing the patient to rest while the situation is observed. Many will settle or progress naturally into true labour.
Conclusion: Sedate the patient and wait, so the answer is option A.