A 24-year-old primigravida at 39 weeks is being induced with oxytocin infusion for post-dated pregnancy. Contractions now occur every 2 minutes lasting 90 seconds, and CTG shows recurrent variable decelerations with minimal variability. What is the MOST appropriate immediate step?
- A Increase the oxytocin infusion rate to achieve regular contractions
- B Perform immediate cesarean section
- C Stop the oxytocin infusion, reposition the mother to left lateral, and give an intravenous crystalloid bolus ✓
- D Perform artificial rupture of membranes to accelerate labour
Correct answer: C. Stop the oxytocin infusion, reposition the mother to left lateral, and give an intravenous crystalloid bolus
Explanation
Uterine tachysystole with a non-reassuring tracing during oxytocin induction is managed first by removing the cause: stop the infusion, move the mother to the left lateral position to relieve aortocaval compression and cord compression, and administer an intravenous fluid bolus. Subcutaneous terbutaline 0.25 mg is added if hyperstimulation persists. Immediate cesarean is reserved for a persistent Category III tracing despite these measures. Raising the oxytocin dose or doing amniotomy would worsen contraction frequency and cord compression.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.