Protraction and arrest disorders Quiz: Ace Your Exams

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A 30-year-old woman, gravida 1, para 0, presents with regular uterine contractions at 40 weeks of estimated gestational age (EGA). She has no loss of fluid, vaginal bleeding, or decreased fetal movement. Her pregnancy is notable for excessive maternal weight gain of 48 lbs (21.7 kg). She has had one prior vaginal delivery at 37 weeks EGA, and her only medication is a prenatal vitamin. Temperature is 36.9°C (98.4°F), pulse is 88/min, respirations are 18/min, and blood pressure is 116/74 mmHg. On exam, the patient appears uncomfortable during contractions but is otherwise well. A pelvic exam is performed, and the patient is admitted to labor. Maternal-fetal cardiotocographic monitoring demonstrates a Category I fetal heart rate pattern. An epidural is placed. Several hours later, the cervix exam is repeated, and it is unchanged from her previous exam. The patient is diagnosed with arrest of labor and cesarean delivery is recommended. Which of the following findings would support this diagnosis and management plan?

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Exam results (dilation / effacement / station)	Time between initial and repeat exams	Membrane status	Montevideo units (MVU)
10 cm /100%/ +3 cm	2 hours	Ruptured	200

Exam results (dilation / effacement / station)	Time between initial and repeat exams	Membrane status	Montevideo units (MVU)
7 cm / 70% / +1 cm	4 hours	Intact	250

Exam results (dilation / effacement / station)	Time between initial and repeat exams	Membrane status	Montevideo units (MVU)
5 cm / 50% / -1 cm	6 hours	Ruptured	240

Exam results (dilation / effacement / station)	Time between initial and repeat exams	Membrane status	Montevideo units (MVU)
6 cm / 60% / 0 cm	4 hours	Ruptured	180

Exam results (dilation / effacement / station)	Time between initial and repeat exams	Membrane status	Montevideo units (MVU)
8 cm / 80% / +1 cm	4 hours	Ruptured	220