cesarian section q . easy? - sriganesh

[ArchivalUser]

A 26-year-old woman, gravida 2, para 1 at 39 weeks of gestation is admitted to the hospital in labor. Her cervix is dilated 5 cm and is 100% effaced, and fetal vertex is at + 1 station. You perform amniotomy and obtain 3+ meconium. You place a fetal scalp monitor and an intrauterine pressure catheter and you start amnioinfusion with normal saline. Fetal monitoring strip reveals five contractions in 10 minutes, and each contraction produces 50 mmHg of pressure. Three hours later, her cervix is 5 cm dilated and 100% effaced, and fetal vertex is at + 1 station. What is the next best step in management?


A. Augmentation with oxytocin
B. Cesarean section
C. Vacuum delivery
D. Magnesium sulfate
E. Methergine

[ArchivalUser]

CS..

[ArchivalUser]

B. Emergency CS
Indication... active phase arrest..no more than 5 cm in 3 hrs
no more hd decent .. station at +1 for 3 hr
additional factors.. grad 3 meconium, hypertonic ut contraction (5 in 10min, normal should not be more than 3 in 10)