Epidural Analgesia in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#11707

SMLE Question #11707

Obstetrics & Gynecology General Gynecology

Objective: OBJ-ETH-STERIL

Last updated: February 2026
A 27-year-old primigravida at 40+2 weeks is in the second stage of labor with epidural analgesia. She has been pushing for 2 hours and reports severe exhaustion with ineffective pushing. Continuous fetal monitoring shows minimal variability with recurrent late decelerations. Vaginal examination shows full cervical dilation; the fetus is cephalic, occiput anterior at +2 station, with a clinically adequate pelvis and no suspected cephalopelvic disproportion. What is the most appropriate next step in management?

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