Question:
Interpret the partogram shown below and identify the most likely diagnosis:
Interpret the partogram shown below and identify the most likely diagnosis:
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Strong contractions but the head is stuck at 2/5: think mechanical obstruction.
Updated On: Jun 23, 2026
- Cephalopelvic disproportion (CPD)
- Maternal exhaustion
- Inadequate uterine contractions
- Rupture uterus
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The Correct Option is A
Solution and Explanation
Answer: Cephalopelvic disproportion (CPD).
Trace the labour from the partogram:
At 7 AM: cervix 4 cm dilated, head 5/5 palpable per abdomen.
After 2 hours: cervix 5 cm, head 3/5.
At 11 AM (4 hours): cervix 7 cm, head 2/5, then cervix reaches full 10 cm.
Key point: uterine contractions are strong, yet after 4 hours the head stays fixed at 2/5 and does not descend further. The cervix dilates but the head does not descend, this is arrest of descent in the presence of good contractions.
When contractions are adequate but descent is arrested, the commonest cause is cephalopelvic disproportion, the fetal head is too large for the maternal pelvis.
Why not the others: inadequate contractions would show weak/infrequent activity (not the case here); maternal exhaustion and uterine rupture present with different clinical signs (rupture with sudden pain, bleeding, fetal distress and loss of contractions). Ref: WHO/IMPAC, Unsatisfactory progress in labour
Trace the labour from the partogram:
At 7 AM: cervix 4 cm dilated, head 5/5 palpable per abdomen.
After 2 hours: cervix 5 cm, head 3/5.
At 11 AM (4 hours): cervix 7 cm, head 2/5, then cervix reaches full 10 cm.
Key point: uterine contractions are strong, yet after 4 hours the head stays fixed at 2/5 and does not descend further. The cervix dilates but the head does not descend, this is arrest of descent in the presence of good contractions.
When contractions are adequate but descent is arrested, the commonest cause is cephalopelvic disproportion, the fetal head is too large for the maternal pelvis.
Why not the others: inadequate contractions would show weak/infrequent activity (not the case here); maternal exhaustion and uterine rupture present with different clinical signs (rupture with sudden pain, bleeding, fetal distress and loss of contractions). Ref: WHO/IMPAC, Unsatisfactory progress in labour
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