Question:hard
Interpret the partogram shown below and identify the most likely diagnosis:
Interpret the partogram shown below and identify the most likely diagnosis:
Show Hint
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
Show Solution
The Correct Option is A
Solution and Explanation
Logic of the partogram: the partogram plots two things, cervical dilatation and head descent, against time, and the contradiction here is the clue. Dilatation moves nicely from 4 to 10 cm, but descent stalls, the head sticks at 2/5 for the last few hours despite contractions that are recorded as strong.
Now apply the labour-arrest rule. Arrest of descent in the face of good, adequate contractions means the power is fine but the passage or passenger is the problem, that is mechanical obstruction, and its commonest cause is cephalopelvic disproportion.
Eliminate the rest: inadequate uterine contractions would be charted as weak or infrequent waves, but here the contractions are strong, so the power is not the issue. Maternal exhaustion is a clinical state, not what the descent line shows. Uterine rupture announces itself dramatically, sudden severe pain, cessation of contractions, vaginal bleeding, fetal distress and a rising pulse, none of which fits a steadily progressing dilatation curve. The stalled descent with strong contractions therefore points to CPD. Ref: WHO partogram guidance.
Now apply the labour-arrest rule. Arrest of descent in the face of good, adequate contractions means the power is fine but the passage or passenger is the problem, that is mechanical obstruction, and its commonest cause is cephalopelvic disproportion.
Eliminate the rest: inadequate uterine contractions would be charted as weak or infrequent waves, but here the contractions are strong, so the power is not the issue. Maternal exhaustion is a clinical state, not what the descent line shows. Uterine rupture announces itself dramatically, sudden severe pain, cessation of contractions, vaginal bleeding, fetal distress and a rising pulse, none of which fits a steadily progressing dilatation curve. The stalled descent with strong contractions therefore points to CPD. Ref: WHO partogram guidance.
Was this answer helpful?
0
