A primigravida at term is in the second stage of labour. The vertex is at +2 station, occipitoanterior position, with recurrent late decelerations on CTG. The cervix is fully dilated. According to RCOG guidelines, what is the maximum recommended duration of the second stage in a nullipara with epidural analgesia before diagnosing delay?

• A 1 hour
• B 2 hours
• C 3 hours
• D 4 hours ✓

Explanation

RCOG guidelines define prolonged second stage as exceeding 4 hours in a nullipara with epidural analgesia and 3 hours without epidural. For multiparas, the limits are 3 hours with epidural and 2 hours without. These time limits apply when there is no progress in descent or rotation.

Reference: RCOG Green-top Guideline No. 26a, 2024 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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