According to current ACOG definitions, what is the maximum duration of the second stage of labour in a nulliparous woman receiving epidural analgesia before it is classified as prolonged?
- A 2 hours
- B 3 hours
- C 4 hours ✓
- D 5 hours
Correct answer: C. 4 hours
Explanation
Contemporary ACOG obstetric care consensus allows a nullipara 3 hours of pushing, extended by 1 additional hour if epidural analgesia is used, giving a total of 4 hours before the second stage is called prolonged. For a multipara the limits are 2 hours, or 3 hours with an epidural. The older Friedman-based 2-hour rule has been abandoned because longer second stages without maternal or fetal compromise are associated with safe vaginal outcomes.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.