A primigravida being augmented with oxytocin develops contractions every 90 seconds lasting 75 seconds. The CTG shows recurrent late decelerations with reduced variability. What is the FIRST step in management?

• A Immediate cesarean section
• B Perform amniotomy to speed delivery
• C Administer a tocolytic bolus of terbutaline
• D Discontinue the oxytocin infusion ✓

Explanation

With tachysystole and an abnormal fetal heart rate pattern, the first step is to stop the oxytocin infusion, since its half-life is only a few minutes and contractions often settle promptly. Supportive measures follow: left lateral tilt, intravenous fluid bolus, and oxygen if needed. Terbutaline and cesarean are reserved for cases that do not resolve after these initial steps.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.