A 38-week primigravida undergoes induction with 25 mcg misoprostol vaginally. After 4 doses, the Bishop score has risen from 3 to 7. Oxytocin augmentation is commenced. After 2 hours of regular contractions, electronic fetal monitoring shows late decelerations with reduced variability. The pattern most consistent with this CTG is categorized as:

• A FIGO 2015 suspicious — requires conservative measures and continue monitoring
• B FIGO 2015 pathological — requires immediate corrective measures and delivery if no improvement ✓
• C NICE category II (indeterminate) — requires closer surveillance but not immediate delivery
• D ACOG Category III (abnormal) — requires immediate intervention and expeditious delivery

Explanation

Late decelerations with reduced variability represent a FIGO 2015 'pathological' CTG pattern (or ACOG Category III) because it combines two ominous features: late decelerations (uteroplacental insufficiency pattern) with reduced/absent baseline variability (suggesting fetal acidemia or CNS depression). FIGO 2015 classifies CTG as normal, suspicious, or pathological; pathological requires immediate corrective measures (lateral decubitus, IV fluids, stop oxytocin, supplemental oxygen) and delivery if no improvement within 30 minutes. NICE classification (C) uses different terminology and category system. This is not merely 'suspicious' (A) as the combination of late decels + reduced variability is the highest-risk combination in FIGO classification.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.