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Latent phase of labour — DRCOG MCQ

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HardLabourLatent phase of labourDRCOG

A low-risk nulliparous woman at 39+2 weeks has painful contractions every 8–10 minutes. Membranes are intact, fetal movements are normal and vaginal examination shows 3 cm dilatation without progressive change over two hours. What is the best plan?

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Correct answer: B — Manage as latent labour with analgesia, support, individualised review and agreed return criteria

Explanation lettering: B = shown as A · E = shown as B · D = shown as C · A = shown as D · C = shown as E

E is correct. NICE defines the latent first stage as contractions with cervical change up to 4 cm; established labour requires regular contractions with progressive dilatation from 4 cm. In a low-risk woman without concerning features, individualised support, analgesia and safety-netting are appropriate. A applies the wrong cervical threshold and introduces intervention. B diagnoses delay before established labour. C treats a normal latent phase as an indication for induction. D omits return advice for bleeding, membrane rupture, reduced movements, escalating pain or other concerns. Her wishes, coping, travel and access to reassessment should shape whether she remains or returns home.

Reference: NICE NG235: Intrapartum care—recommendations: https://www.nice.org.uk/guidance/ng235/chapter/recommendations