Question

A primigravida presents to the labor room at 40 weeks of gestation with lower abdominal pain. She has been in labor for 3 hours. Which of the following will determine if she is in active labor?

• A. Fetal head 5/5 palpable on abdominal examination
• B. Two contractions lasting for 10 seconds in 10 minutes
• C. More than 5 cm cervical dilatation with complete effacement
• D. Rupture of membranes

Answer 1

The Correct Option is C

To determine if a primigravida is in active labor, one should assess the cervical dilatation and effacement. Active labor generally starts when cervical dilatation exceeds 5 cm with complete effacement. Here's why different indicators are significant:

Indicator	Significance
Fetal head 5/5 palpable on abdominal examination	A fetal head 5/5 palpable suggests it is still high in the pelvis, not currently indicative of active labor.
Two contractions lasting for 10 seconds in 10 minutes	The frequency and duration of contractions are insufficient to suggest active labor, as typical contractions in active labor are more frequent and longer-lasting.
More than 5 cm cervical dilatation with complete effacement	This indicates active labor, as the cervix has dilated sufficiently (beyond 5 cm), and complete effacement suggests progression towards delivery.
Rupture of membranes	While this can be a sign of labor progression, it alone does not confirm active labor without cervical changes.

Therefore, the correct determinant of active labor is "More than 5 cm cervical dilatation with complete effacement". This combination suggests that the labor is advancing towards delivery.