A 24-year-old primigravida at term is being induced with oxytocin. Contractions occur 6 times in 10 minutes and the CTG shows recurrent late decelerations with moderate variability. What is the FIRST step in management?

• A Immediate cesarean delivery
• B Amnioinfusion
• C Intravenous terbutaline bolus
• D Stop or reduce the oxytocin infusion and change maternal position ✓

Explanation

Tachysystole with late decelerations during oxytocin induction is managed first by removing the cause: stopping or halving the oxytocin infusion, maternal repositioning, and intravenous fluid bolus. Terbutaline is reserved for cases where hyperstimulation persists despite stopping oxytocin. Cesarean is indicated only if the tracing progresses to Category III despite conservative measures. Amnioinfusion addresses recurrent variable decelerations from cord compression, not late decelerations from hyperstimulation.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.