North American Registry of Midwives (NARM) Practice Exam

Uterine dysfunction is diagnosed by observing what specific condition?

1. Cervical effacement without dilation

2. Prolongation of any phase of labor

3. Consistent fetal heart rate

4. Frequent contractions

The correct answer is: Prolongation of any phase of labor

The diagnosis of uterine dysfunction is closely associated with the prolongation of any phase of labor. This essentially indicates that the contractions are ineffective in progressing labor, leading to extended durations in the latent, active, or transitional stages. In a normal labor process, the phases should progress in a timely manner, with cervical changes and descent of the fetus occurring at expected intervals. When labor phases are prolonged, it suggests that the uterine contractions may not be sufficiently strong or coordinated to facilitate these changes, which is a hallmark sign of uterine dysfunction. Cervical effacement without dilation, while it can indicate a specific situation in labor, does not directly correlate with the broader concept of uterine dysfunction, as effacement can occur without being indicative of dysfunctional labor patterns. Consistent fetal heart rate generally represents a stable condition for the fetus and does not provide direct insights into the effectiveness of uterine contractions. Frequent contractions might suggest some level of uterine activity; however, they do not necessarily indicate progression in labor, as they could be ineffective in promoting cervical change, which is a critical component when assessing uterine function. Therefore, the evaluation of prolonged phases of labor is essential for identifying uterine dysfunction accurately.