According to contemporary ACOG criteria, what is the MINIMUM duration of the second stage of labour that should elapse before diagnosing second stage arrest in a nulliparous woman WITH epidural analgesia, assuming maternal and fetal status remain reassuring?
- A 2 hours
- B 3 hours
- C 4 hours ✓
- D 5 hours
Correct answer: C. 4 hours
Explanation
ACOG redefined labour arrest criteria allow a nullipara with epidural analgesia at least 4 hours of pushing before arrest of second stage is diagnosed, because longer second stages are associated with normal neonatal outcomes when the tracing is reassuring. Without epidural the threshold is 3 hours. For multiparas the thresholds are 2 hours without and 3 hours with epidural. Diagnosing arrest earlier leads to unnecessary operative intervention.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.