Maternity Nursing Q 84
The normal dilatation of the cervix during the first stage of labor in a nullipara is
A. 1.2 cm./hr
B. 1.5 cm./hr.
C. 1.8 cm./hr
D. 2.0 cm./hr
Correct Answer: A. 1.2 cm./hr
For nullipara, the normal cervical dilatation should be 1.2 cm/hr. If it is less than that, it is considered a protracted active phase of the first stage. For multipara, the normal cervical dilatation is 1.5 cm/hr.
Option B: For nulliparous women, Friedman (Friedman Studies) reported that the active phase of labor approximates the time from 2.5 cm cervical dilatation through complete dilatation, approximated at 10 cm. Use of 2.5 cm dilatation as the onset of active labor was an aggregate estimate and was, therefore, not strictly applicable to any individual woman.
Option C: Active phase labor was further divided into three sub-phases, i.e., an acceleration phase, a phase of maximum slope, and a deceleration phase. Friedman described the acceleration phase as a rapid change in the slope of cervical dilation approximating the time needed for the cervix to dilate from 2.5 cm to 4 cm, and the phase of maximum slope as a period of rapid cervical dilation progressing linearly from approximately 4 cm to 9 cm cervical dilatation. Friedman reported the mean and slowest-yet-normal (i.e., mean – 2 standard deviations) cervical dilation rates in the phase of maximum slope to be 3.0 and 1.2 cm/hr, respectively.
Option D: The deceleration phase was identified when the rate of dilation once again slowed as full dilatation was reached. For the aggregate of all labors, this phase approximated the time needed for the cervix to dilate from 9 cm to 10 cm. Friedman included data from some women without a spontaneous labor onset and some who were not low-risk by modern standards.