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A 32 year old woman, G3P2 @ term is admitted to hospital @ labor. contractions have occurred every 3 minutes for past 8 hours. her temp is 37^c (98.6^f), pulse 80/min, RR=20, BP=120/80. cervix is 100% effacced and 4cm dilated, the vertex is at -2 station. membranes rupture suddenly, yielding a large amount if clear fluid. the FHR decreases to 90/min. what is the most appropriate next step in Mx??
a. Pelvic examination
b. external cephalic
c. internal podalic
d. atropine
e. oxytocin
f. forceps delivery
plz explain too.
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It looks like there is a fetal vessel prolapse so
A. I think it WRONG, because we need something emergent, although it may be RIGHT if we want to visualize prolapsed umbilical cord
B. WRONG, here is emergent situation and this baby is not in breech presentation
C. I am not sure, but I think is helpful for twins, when second child in breech -> WRONG
D. I do not know how it could help, so it is also WRONG
E. I think we will make worse with oxytocin, so it is WRONG
F. This option sounds like smth emergent and although here is only 4cm dilation I think is should be RIGHT
Although I do know why C-section is not among the choices
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I checked it - the right answer is A -> we need to visualize prolapsed cord and then go to C-section
