- 1. Turn patient to left, lateral side.
-
Correct.
This relieves compression on the IVC increasing cardiac output and
therefore uterine perfusion.
Incorrect.
This relieves compression on the IVC increasing cardiac output and
therefore uterine perfusion.
- 2. Change maternal position to various positions until
fetal improvement.
-
Correct.
This only useful with cord compression of which there is no evidence.
Incorrect.
There
is no evidence of cord compression, so this maneuver is not likely to
be beneficial.
- 3. Fluid bolus, lower maternal head.
-
Correct.
These efforts may help improve maternal cardiac output and therefore
uterine perfusion, though this could precipitate pulmonary edema and
should be used cautiously.
Incorrect.
These efforts may help improve maternal cardiac output and
therefore uterine perfusion, though this could precipitate pulmonary
edema and should be used cautiousl
y.
- 4. Vasopressor (e.g. Ephedrine).
-
Correct.
There is no evidence of maternal hypotension.
Incorrect.
There
is no evidence of maternal hypotension.
- 5. Supplemental Oxygen.
-
Correct.
Though controversial, O2 may be of benefit to the fetus in this case.
Incorrect.
Though controversial, O2 may be of benefit to the fetus in this case.
- 6. Stop Magnesium Sulfate.
-
Correct.
Stopping magnesium here will not benefit the fetus and may harm the
mother.
Incorrect.
Stopping magnesium here will not benefit the fetus and may harm the
mother.
- 7. Give tocolytic (e.g. Terbutaline).
-
Correct.
There are rarely times when this will prove beneficial and there is no
evidence of hypertonus.
Incorrect.
There are rarely times when this will prove beneficial.
- 8. Perform vaginal exam.
-
Correct.
Though not contraindicated, this is not likely to be beneficial.
Incorrect.
Though
not contraindicated, this is not likely to be beneficial.
- 9. Perform emergent Cesarean delivery or operative
vaginal delivery if the possible
-
Correct.
Intrauterine resuscitation should be attempted first.
Incorrect.
Intrauterine rescucitation should be attempted first.
- 10. Perform fetal scalp stimulation.
-
Correct.
Fetal scalp stimulation should never be performed in the presence of
late decelerations.
Incorrect.
Fetal scalp stimulation should never be performed in the presence of
late decelerations.
