A 30-year-old G2P1 at 40 weeks develops a Category III CTG with persistent late decelerations and absent variability. The cervix is 9 cm dilated, fully effaced, and the fetal head is at +2 station in an OA position. Which is the MOST appropriate management?
- A Operative vaginal delivery with ventouse or forceps ✓
- B Immediate cesarean section
- C Intrauterine resuscitation and expectant management
- D Fetal blood sampling before deciding management
Correct answer: A. Operative vaginal delivery with ventouse or forceps
Explanation
Category III CTG (absent variability with recurrent late decelerations) requires prompt delivery. With the cervix fully dilated, head at +2 station in an OA position, and a multiparous patient, the conditions are favorable for operative vaginal delivery (ventouse or forceps), which is faster and less morbid than cesarean section at this stage. Operative vaginal delivery should be attempted only when conditions are met; if unsuccessful, cesarean section follows immediately.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.