# Situation: A 24-year-old primigravida at 39 weeks' gestation comes to a lying-in clinic at 02:00 because of abdominal tightening since midnight. Her membranes are intact, she has no vaginal bleeding, and she reports active fetal movement. Her prenatal course has been uncomplicated. Hours later, the client's contractions have become regular. The nurse palpates and times three consecutive contractions: Contraction 1: begins 10:00:00, ends 10:00:45 Contraction 2: begins 10:03:30, ends 10:04:15 Contraction 3: begins 10:07:00, ends 10:07:45 How should the nurse document the frequency and duration of these contractions?

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> subject: Nursing Practice II — Maternal and Child Health Nursing

## 문제

Situation: A 24-year-old primigravida at 39 weeks' gestation comes to a lying-in clinic at 02:00 because of abdominal tightening since midnight. Her membranes are intact, she has no vaginal bleeding, and she reports active fetal movement. Her prenatal course has been uncomplicated.

Hours later, the client's contractions have become regular. The nurse palpates and times three consecutive contractions:
Contraction 1: begins 10:00:00, ends 10:00:45
Contraction 2: begins 10:03:30, ends 10:04:15
Contraction 3: begins 10:07:00, ends 10:07:45
How should the nurse document the frequency and duration of these contractions?

## 보기

1. Every 2 minutes 45 seconds, lasting 45 seconds
2. Every 4 minutes 15 seconds, lasting 45 seconds
3. Every 3 minutes 30 seconds, lasting 2 minutes 45 seconds
4. Every 3 minutes 30 seconds, lasting 45 seconds **✔ 정답**

**정답: 4**

## 해설

Frequency is measured from the start of one contraction to the start of the next: 10:00:00 to 10:03:30 and 10:03:30 to 10:07:00 are both 3 minutes 30 seconds. Duration is measured from the start to the end of one contraction: 45 seconds each. The 2 minutes 45 seconds between the end of one contraction and the start of the next is the resting interval, not the frequency.

## 심화 해설

Understanding Contraction Timing

The key to this question is distinguishing between frequency, duration, and the resting interval. These are separate parameters, and mixing them up is a common error when documenting uterine activity.

Frequency is measured from the start of one contraction to the start of the next contraction. Using the data provided, the interval from 10:00:00 to 10:03:30 is 3 minutes 30 seconds, and the interval from 10:03:30 to 10:07:00 is also 3 minutes 30 seconds. This consistency confirms a regular contraction pattern with a frequency of every 3 minutes 30 seconds.

Duration is measured from the beginning to the end of a single contraction. Each contraction begins and ends 45 seconds later, so the duration is 45 seconds. The time between the end of one contraction and the start of the next—here, 2 minutes 45 seconds—is the resting interval, not the frequency. Option 1 incorrectly uses this resting interval as the frequency.

Watch out! When reading a monitor strip or palpating, always anchor your measurement to the *start* of each contraction for frequency. Counting from the end of one to the start of the next will underestimate the true frequency and misrepresent labor progress.

Key point! In clinical practice, contraction parameters such as frequency, duration, and resting tone are routinely assessed to evaluate labor progress and uterine contractility. Research on uterine activity—whether by external tocodynamometry, palpation, or investigational methods like surface uterine electromyography—relies on clearly separating these timing definitions to ensure accurate documentation and clinical decision-making [1][2].

For a primigravida at term with regular contractions every 3 minutes 30 seconds lasting 45 seconds, the nurse would document active labor characteristics and continue monitoring fetal well-being and cervical change. The intact membranes and active fetal movement are reassuring, but the regularity and timing of contractions are the focus of this assessment.References (research sources)

- [1]Use of External Uterine Electromyography Across Stage I Labor.Research articleBenfield R, Newton ER (2023) · DOI: 10.1111/jmwh.13501

- [2]Uterine Contraction Parameters Before and During the Pre-Epidural Fluid Bolus: A Pilot Study.Research articleBenfield R, Feng D, Salstrom J, Edge M, Brigham D, Newton ER (2019) · DOI: 10.1177/1099800419858667

## 임상 시나리오

Contraction Timing: Frequency vs DurationAccurate documentation of uterine activity in labor
Measure frequency from the start of one contraction to the start of the next. In this case, both intervals are 3 minutes 30 seconds, confirming a regular pattern.

Measure duration from the beginning to the end of a single contraction. Each contraction lasts 45 seconds.

CautionDo not confuse the resting interval (end of one to start of next, here 2 minutes 45 seconds) with frequency. Counting from the end of one contraction to the start of the next will underestimate true frequency and misrepresent labor progress.

## 핵심 개념

- **Frequency** — Time from the start of one contraction to the start of the next contraction
- **Duration** — Time from the beginning to the end of a single contraction
- **Resting interval** — Time from the end of one contraction to the start of the next contraction
- **Tocodynamometry** — External monitoring of uterine contraction frequency and duration
- **Primigravida** — A woman pregnant for the first time

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