Question:medium
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 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?
Show Hint
No cervical progress after 10 hours means false labour, so reassure and observe.
Updated On: Jun 24, 2026
- Sedate the patient and wait
- LSCS
- Amniotomy
- Induction with membrane rupture
Show Solution
The Correct Option is A
Solution and Explanation
The decisive clue is the mismatch between symptoms and cervical change. The woman has had painful, regular-feeling contractions for ten full hours, yet her cervix has dilated only to one centimetre and has not effaced at all. Established labour is defined by a cervix that is actively thinning and opening; when contractions persist but the cervix stubbornly stays unchanged, the picture fits false labour or an early latent phase rather than active labour. Recognising this changes the whole management plan. There is no fetal distress, no malpresentation and no failure to progress in active labour, so there is no reason to rush to a caesarean section. Likewise, artificially rupturing the membranes or formally inducing labour would be forcing intervention on a uterus that has not yet entered true labour, which is unnecessary and potentially harmful. The appropriate response is supportive: give the mother analgesia and a sedative so she can rest, then observe her. Under observation she will either settle down or transition naturally into genuine labour. So the right management is conservative. \[\boxed{\text{Sedate the patient and wait}}\]
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