Obstetrics & Gynaecology · Labour Abnormalities, Induction and Operative Delivery

According to contemporary ACOG criteria, what is the threshold for diagnosing prolonged second stage of labour in a nulliparous woman labouring WITH epidural analgesia?

  • A 2 hours
  • B 3 hours
  • C 4 hours
  • D 5 hours
Correct answer: C. 4 hours

Explanation

The redefined ACOG limits are 3 hours for a nullipara without epidural and 4 hours with epidural; for a multipara the limits are 2 hours without and 3 hours with epidural. Epidural analgesia slows descent and rotation, so one extra hour is allowed. Option B applies to a nullipara without regional anaesthesia, and option A applies to a multipara without one, so both fail for this scenario.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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