According to contemporary ACOG criteria, arrest of the second stage of labour in a NULLIPAROUS woman with continuous epidural analgesia is diagnosed when there is no progressive descent after how many hours of pushing?
- A 2 hours
- B 3 hours
- C 4 hours ✓
- D 5 hours
Correct answer: C. 4 hours
Explanation
Contemporary ACOG criteria define second stage arrest in a nullipara at 3 hours without regional anaesthesia and 4 hours with epidural analgesia; corresponding values for multiparas are 2 and 3 hours respectively. The older strict two-hour rule led to unnecessary operative intervention, and extended pushing durations allow spontaneous delivery without added maternal or neonatal harm provided maternal and fetal status remain reassuring.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.