According to contemporary ACOG criteria, how long may the second stage be allowed to continue in a nulliparous woman with effective epidural analgesia before arrest of the second stage is diagnosed?
- A 2 hours
- B 3 hours
- C 4 hours ✓
- D 5 hours
Correct answer: C. 4 hours
Explanation
Contemporary ACOG criteria allow a nullipara 3 hours of second stage without epidural and 4 hours with epidural analgesia; corresponding multipara limits are 2 and 3 hours respectively. Diagnosis before these intervals risks unnecessary operative intervention, since many women deliver normally beyond older Friedman-based limits. The 3-hour figure applies only to a nullipara without epidural, which is the trap this stem sets.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.