A primigravida being induced at 40 weeks receives oxytocin infusion. Contractions are occurring 7 times in 10 minutes and the CTG shows recurrent variable decelerations with moderate variability. The cervix is 5 cm dilated. What is the FIRST step in management?
- A Stop the oxytocin infusion and reposition the mother to the left lateral side ✓
- B Proceed to emergency caesarean section
- C Increase the oxytocin dose to overcome the decelerations
- D Perform immediate amniotomy
Correct answer: A. Stop the oxytocin infusion and reposition the mother to the left lateral side
Explanation
This tracing shows tachysystole (more than 5 contractions in 10 minutes) with a Category II pattern. The first response to abnormal fetal heart rate with uterine tachysystole during oxytocin induction is discontinuation of the oxytocin, maternal repositioning, intravenous fluid bolus and assessment. Caesarean is premature because variability indicates fetal compensation and removal of the drug often restores a normal tracing. Escalating the dose would worsen the hyperstimulation.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.