A woman at 42 weeks of gestation is induced with dinoprostone gel. After 6 hours, she develops tachysystole (6 contractions in 10 minutes) with late decelerations on CTG. The cervix is 3 cm dilated. What is the most appropriate immediate management?
- A Increase oxytocin infusion rate
- B Administer intravenous terbutaline ✓
- C Perform emergency cesarean section
- D Remove the dinoprostone and observe
Correct answer: B. Administer intravenous terbutaline
Explanation
Tachysystole with late decelerations indicates uterine hyperstimulation with fetal compromise. The first step is tocolysis with a rapidly acting agent such as terbutaline to relax the uterus and improve placental perfusion. If fetal distress persists despite tocolysis, emergency delivery is indicated.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.