04-20-2008, 01:00 PM
A 19-year-old primigravid woman at 42 weeks' gestation comes the labor and delivery ward for induction of labor. Her prenatal course was uncomplicated. Examination shows her cervix to be long, thick, closed, and posterior. The fetal heart rate is in the 140s and reactive. The fetus is vertex on ultrasound. Prostaglandin (PGE2) gel is placed intravaginally. One hour later, the patient begins having contractions lasting longer than 2 minutes. The fetal heart rate falls to the 70s. Which of the following is the most appropriate next step in management?
A. Administer general anesthesia
B. Administer terbutaline
C. Perform amnioinfusion
D. Start oxytocin
E. Perform cesarean delivery
A. Administer general anesthesia
B. Administer terbutaline
C. Perform amnioinfusion
D. Start oxytocin
E. Perform cesarean delivery