A 27-year-old primigravida at 40 weeks is in the second stage of labor. The fetal head is at +3 station, occiput anterior. She has been pushing for 1.5 hours. The CTG shows recurrent variable decelerations with slow return to baseline. The most appropriate management is:
- A Continue pushing for another hour
- B Perform outlet forceps delivery ✓
- C Perform cesarean section
- D Administer oxytocin
Correct answer: B. Perform outlet forceps delivery
Explanation
With the head at +3 station and recurrent variable decelerations with slow recovery, operative vaginal delivery is indicated if the patient is fully dilated. Outlet forceps can be applied when the head is at or below +2 station. Cesarean section is not necessary given the low station. Continuing to push or giving oxytocin would delay delivery in a non-reassuring fetal status.
Reference: Dutta's Textbook of Obstetrics, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.