A 30-year-old primigravida at 40 weeks is in active labor. She has been fully dilated for 2 hours with epidural analgesia. The fetal head is at +1 station, occiput posterior. CTG is normal. What is the most appropriate management?
- A Allow up to 3 hours of pushing with epidural ✓
- B Immediate cesarean section
- C Perform manual rotation and forceps delivery
- D Administer oxytocin
Correct answer: A. Allow up to 3 hours of pushing with epidural
Explanation
Second stage arrest in a nullipara with epidural analgesia is diagnosed after 3 hours of pushing. Since only 2 hours have elapsed and the CTG is normal, continued observation is appropriate. Immediate cesarean is not indicated. Manual rotation and forceps may be considered if arrest persists. Oxytocin is not needed as contractions are presumably adequate.
Reference: Williams Obstetrics, 25th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.