- 1. Turn patient to left, lateral side.
-
Correct.
The correct approach is to rotate through various positions until cord
compression is relieved. This may be left, lateral, but not necessarily.
Incorrect.
The correct approach is to rotate through various positions until cord
compression is relieved. This may be left, lateral, but not necessarily.
- 2. Change maternal position to various positions until
fetal improvement.
-
Correct.
This is useful with cord compression of which the variable decels may
represent.
Incorrect.
This is useful with cord compression of which the variable decels may
represent.
- 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. Start amnioinfusion.
-
Correct.
An amnioinfusion is indicated for recurrent severe variable
decelerations.
Incorrect.
An amnioinfusion is indicated for recurrent severe variable
decelerations.
- 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.
An exam may reveal the presence of a prolapsed cord and will allow the
physician to know whether operative delivery is possible.
Incorrect.
An exam may reveal the presence of a prolapsed cord and will allow thephysician to know whether operative delivery is possible.
- 9. Perform expeditious (emergent) delivery (operative
vaginal delivery or Cesarean delivery)
-
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
recurrent variable decelerations.
Incorrect.
Fetal scalp stimulation should never be performed in the presence ofrecurrent variable decelerations.
