The active phase of labour has the following components?
a. Acceleration phase
b. Phase of maximum slope
c. Plateau phase
d. Phase of deceleration

Appeared in: MNS 2024

Explanation

The first stage of labor is divided into a latent phase and an active phase.
According to Friedman's classic model, the active phase is further subdivided into three parts: the acceleration phase, the phase of maximum slope, and the deceleration phase.
The acceleration phase marks the beginning of rapid dilation.
The phase of maximum slope is when cervical dilation occurs at its fastest rate.
The deceleration phase is when dilation slows as the cervix approaches 10 cm.
Therefore, the combination of components a, b, and d accurately describes the active phase of labor.

Option B: This option is incorrect because it includes 'C' (Plateau phase), which is not a recognized component of the active phase of labor according to Friedman's curve.
Option C: This option is incorrect because it includes 'C' (Plateau phase). The active phase consists of acceleration, maximum slope, and deceleration phases only.
Option D: This option is incorrect because it includes 'C' (Plateau phase) and omits 'A' (Acceleration phase), which is the initial part of the active phase.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Phases of Active Labor (Friedman's Curve) as background academic context rather than a clinical decision trigger.
Understanding Friedman's curve is crucial for nurses and obstetricians to monitor the progress of labor and identify abnormalities, such as protraction (slower-than-normal progress) or arrest (no progress) disorders.
Plotting a patient's cervical dilation against time on a partograph allows for a visual comparison to the expected curve, helping to detect deviations that may signal issues like cephalopelvic disproportion or ineffective uterine contractions.
Early identification of abnormal labor patterns allows for timely interventions, such as oxytocin augmentation or consideration for cesarean delivery, which can improve maternal and fetal outcomes.

How to Approach the Question

First, identify that the question asks for the components of the 'active phase' of labor.
Recall the classic model of labor progression, known as Friedman's curve, which graphically represents cervical dilation over time.
Remember that the first stage of labor is divided into two main phases: the latent phase (slow, early dilation) and the active phase (rapid dilation).
Recall the three specific subdivisions of the active phase: the acceleration phase, the phase of maximum slope, and the deceleration phase.
Evaluate the given list of components (a, b, c, d). Note that 'Acceleration phase' (a), 'Phase of maximum slope' (b), and 'Phase of deceleration' (d) are all correct parts of the active phase.
Identify that 'Plateau phase' (c) is not a standard component of Friedman's curve.

Concept Tested & Keywords

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E6 Obstetrics Williams p. 22-40

Practise the full MNS 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.