A 34-year-old primigravida at 41 weeks is induced with misoprostol 25 mcg vaginally every 4 hours. After 2 doses, she develops tachysystole (6 contractions in 10 minutes) with late decelerations on CTG. What is the most appropriate immediate management?

• A Administer terbutaline
• B Perform emergency cesarean section
• C Perform amniotomy
• D Discontinue misoprostol and give IV fluids ✓

Explanation

The first step in managing tachysystole with late decelerations is to stop the uterotonic agent and provide supportive care with IV fluids, maternal repositioning, and oxygen. A tocolytic such as terbutaline is administered if the abnormal pattern persists after these measures. Emergency cesarean is reserved for persistent non-reassuring status despite interventions.

Reference: Dutta's Textbook of Obstetrics, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.