Single Best Answer (SBA) · Normal Labour and the Partograph
A midwife is starting a partogram. At what point should the alert line be commenced, and at what rate is it drawn?
Show answer and explanation
Answer: A. From 4 cm or more dilatation, at 1 cm per hour
The partogram alert and action lines
The partogram is a graphic record of labour that aids early recognition of abnormal progress and fetal distress.
Alert and action lines
- Alert line: drawn at 1 cm per hour from the first detection of cervical dilatation of 4 cm or more.
- Action line: drawn parallel, 4 hours to the right of the alert line.
When to start the partogram
- When uterine contractions are 2 or more per 10 minutes, or
- At induction of labour with oxytocin or amniotomy.
Use
Crossing the alert line warns of slow progress; reaching the action line prompts intervention. Cervical dilatation, descent, fetal heart rate, liquor, moulding and maternal observations are all plotted together for an at-a-glance assessment.
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