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Prolonged second stage — DRCOG MCQ

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HardLabourProlonged second stageDRCOG

A 24-year-old nulliparous woman is in the second stage of labour with an epidural. She has been actively pushing for 2 hours, the head is low, position is occipito-anterior and the CTG is normal. She is exhausted and asks what happens next. What is the most appropriate management?

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Correct answer: C — Request obstetric review for possible assisted vaginal birth

Prolonged active second stage with maternal exhaustion should prompt obstetric review and consideration of assisted vaginal birth when prerequisites are met. Continuing for many hours without review is not appropriate. The pearl is that operative vaginal birth decisions depend on station, position, analgesia, maternal condition and fetal status.

Reference: NICE NG235