I am a bit confused regarding the time frame that vaginal birth should take place.
According to the NICE intrapartum guidelines 2007 it states: 'Birth is expected ti take place within 3 hours of start of active second stage for nulliparous women and within 2 hours for parous women" does not specify regarding regional anaesthsia.
On the other hand , the RCOG vaginal operative delivery 2011 guideline states: "Nulliparous women- lack of continuing progress for 3 hours (total of active and passive second-stage labour) with regional anaesthesia or 2 hours without regional anaesthesia. Multiparous women-lack of continuing progress for 2 hours (total of active and passive second stage labour) with regional anaesthesia, or 1 hour without regional anaesthesia."
In practice I follow the RCOG guideline, but if there is an EMQ or MCQ on the exam which time frame are we expected to follow?