A woman is receiving oxytocin augmentation for slow progress. The CTG shows late decelerations with reduced variability. Contractions are 5 in 10 minutes. What is the first action?

• A Apply fetal scalp electrode and continue oxytocin
• B Stop oxytocin, reposition, give oxygen, prepare for emergency CS ✓
• C Reduce oxytocin to half the current rate
• D Perform fetal blood sampling for pH

Explanation

Late decelerations with reduced variability represent a pathological CTG pattern consistent with fetal hypoxia, especially in the setting of tachysystole (5 contractions per 10 minutes). The first action is to stop the oxytocin infusion (to reduce hyperstimulation), reposition the mother (left lateral), administer supplemental oxygen, and prepare for emergency delivery. Fetal blood sampling can be considered once the immediate stimulus (oxytocin) is removed if the pattern does not improve rapidly.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.