If late decelerations persist after initial maternal repositioning and oxygen, what is the recommended next step?

If late decelerations persist after initial maternal repositioning and oxygen, what is the recommended next step?

• A. Prepare for delivery
• B. Resume oxytocin infusion
• C. Proceed to urgent delivery planning
• D. Reassess in 30 minutes

Answer: (C)

Late decelerations reflect fetal hypoxia from placental insufficiency. If they persist after repositioning and giving oxygen, the fetus is not tolerating contractions and time is critical. The next step is to expedite delivery by initiating urgent delivery planning—activate the obstetric team, prepare for delivery, and decide on the quickest safe route (usually cesarean if rapid delivery is needed, or expedite vaginal delivery if feasible). Resuming oxytocin would worsen the pattern, and waiting 30 minutes delays life-saving intervention.

Late decelerations reflect fetal hypoxia from placental insufficiency. If they persist after repositioning and giving oxygen, the fetus is not tolerating contractions and time is critical. The next step is to expedite delivery by initiating urgent delivery planning—activate the obstetric team, prepare for delivery, and decide on the quickest safe route (usually cesarean if rapid delivery is needed, or expedite vaginal delivery if feasible). Resuming oxytocin would worsen the pattern, and waiting 30 minutes delays life-saving intervention.