Obstetrics & Gynecology>>>>>Normal and Abnormal Labor and Delivery
Question 2#

A 30-year-old G2P0 at 39 weeks is admitted in labor with spontaneous rupture of membranes occurring 2 hours prior to admission and regular uterine contractions. On examination, her cervix is 4-cm dilated and completely effaced. The fetal head is at 0 station and the fetal heart tracing is reactive. Two hours later, on repeat examination, her cervix is 5-cm dilated and the fetal head is at +1 station. Early decelerations are noted on the fetal heart tracing.

For the description of labor, select the most appropriate next step in management.

a. Initiate Pitocin augmentation
b. Place an intrauterine pressure catheter (IUPC)
c. Perform a cesarean delivery
d. Place a fetal scalp electrode
e. No intervention; labor is progressing normally

Correct Answer is A

Comment:

The patient has a protracted active phase of labor (cervical dilation < 1.2 cm/h). Either expectant management or Pitocin augmentation may be used for treatment.