According to contemporary ACOG criteria, how long may a nulliparous woman with continuous epidural analgesia push before the second stage is labelled prolonged?
- A 2 hours
- B 3 hours
- C 4 hours ✓
- D 5 hours
Correct answer: C. 4 hours
Explanation
The redefined limits allow a nullipara 3 hours of pushing, extended to 4 hours when epidural analgesia is used; a multipara is allowed 2 hours, extended to 3 with epidural. The key discriminator in this stem is the combination of nulliparity plus epidural, which gives 4 hours. Reaching the limit alone is not an automatic indication for operative delivery; ongoing descent permits continued pushing.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.