NBME Form 9 Practice Test

Protraction of labor during active labor should be managed initially with C-section.

False True Only if fetal distress After prolonged observation

Correct Answer:

False

Explanation:

Protraction in the active phase means cervical dilation is progressing more slowly than expected despite regular contractions. The best first step is to optimize labor, often by augmenting contractions with IV oxytocin and addressing reversible factors such as hydration, analgesia, fatigue, and maternal position. Cesarean delivery is not the initial management for protraction. It becomes appropriate if, after adequate augmentation and optimization, the labor still does not progress (arrests) or if there is nonreassuring fetal status or other contraindications to vaginal delivery. So the initial approach is to augment labor rather than proceed straight to a cesarean.

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