Maternal health: partograph: practice question

A PSM question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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PSM · Maternal health: partograph

Sample item

A labour room nurse is trained to use the modified WHO partograph. Where does plotting of cervical dilatation begin, and where is the action line placed?

AAt 6 cm dilatation, with the action line 1 hour to the rightBAt full dilatation, with no action lineCAt 0 cm dilatation, with the action line 2 hours to the rightDAt 4 cm dilatation, with the action line 4 hours to the right of the alert line

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. At 4 cm dilatation, with the action line 4 hours to the right of the alert line

The modified partograph is started only when the woman is in active labour at a cervical dilatation of 4 cm. The alert line represents progress of 1 cm per hour, and the action line is drawn 4 hours to the right of it. Crossing the action line signals the need for evaluation and intervention for obstructed or prolonged labour.

Option by option

A. At 6 cm dilatation, with the action line 1 hour to the right
Waiting until 6 cm would miss early active labour, and the action line gap is not 1 hour.
B. At full dilatation, with no action line
The partograph is plotted throughout the active phase and always includes an action line.
C. At 0 cm dilatation, with the action line 2 hours to the right
Plotting does not start at 0 cm because the latent phase is not charted on the partograph.
D. At 4 cm dilatation, with the action line 4 hours to the right of the alert line (correct)
Correct. Plotting starts at 4 cm with the action line 4 hours to the right.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this PSM question

What is the answer to this PSM question?

The best answer is D, At 4 cm dilatation, with the action line 4 hours to the right of the alert line. The modified partograph is started only when the woman is in active labour at a cervical dilatation of 4 cm.

Why is "At 6 cm dilatation, with the action line 1 hour to the right" not the answer?

Waiting until 6 cm would miss early active labour, and the action line gap is not 1 hour.

Why is "At full dilatation, with no action line" not the answer?

The partograph is plotted throughout the active phase and always includes an action line.

Why is "At 0 cm dilatation, with the action line 2 hours to the right" not the answer?

Plotting does not start at 0 cm because the latent phase is not charted on the partograph.

What concept does this question test?

It tests Maternal health: partograph in PSM. The alert line represents progress of 1 cm per hour, and the action line is drawn 4 hours to the right of it. Crossing the action line signals the need for evaluation and intervention for obstructed or prolonged labour.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Maternal health: partograph?

Practise biostatistics with small calculations until sensitivity, predictive values and risk measures are automatic. Then use the flashcards and the other PSM questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.