A 24-year-old primigravida at 40 weeks is being induced with oxytocin for post-dated pregnancy. Contractions occur 6 times in 10 minutes, each lasting over 90 seconds, and the CTG shows recurrent late decelerations with moderate variability. The cervix is 4 cm dilated. What is the FIRST step in management?
- A Stop the oxytocin infusion and give a bolus of intravenous fluid ✓
- B Immediate cesarean delivery
- C Increase the oxytocin dose to overcome the decelerations
- D Perform immediate amniotomy
Correct answer: A. Stop the oxytocin infusion and give a bolus of intravenous fluid
Explanation
Oxytocin-induced tachysystole with late decelerations is managed by stopping or reducing the oxytocin infusion, maternal repositioning, and intravenous fluid bolus, since the drug has a short half-life and contractions usually settle within minutes. The tracing shows moderate variability, so it is not a Category III pattern mandating immediate cesarean. Increasing oxytocin would worsen hyperstimulation, and amniotomy may intensify contractions further.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.