DrVirgo
Forum Hero
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38 weeks gestation, admitted to the delivery for management of labor.
Active labor for 4 hours. Cervical dilation progressed from 3-8cm and Descent progressed from -1 to +1 Station. 6 hours later there is the same degree of dilation and descent.
Fetal head is in LOA position. External tocometer shows contractions are 3 minutes apart lasting 50 seconds each. Internal pelvic assesment shows prominent ischial spines. Fetal heart rate is 140bpm with frequent accelerations. Prenatal U/S at 37 weeks showed a fetus of average size. Next step?
A. Forceps Delivery
B. Low Transverse C-section
C. Administer Oxytocin
D. Close observation for 2 more hours.
E. Zavanelli Maneuver
Please answer and explain why.
Thanks.
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| grechita12
Forum Senior
Topics: 4
Posts: 192
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B the pte have midpelvis contraction evidenced by "Internal pelvic assesment shows prominent ischial spines" so that's an arrest in labor (specifically arrest of dilation) and the next step is c-section
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| Markus2009
Forum Senior
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B Same concept DRVirgo, you are really nailing down the concepts, good for you.
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| sherry39
Forum Junior
Topics: 3
Posts: 105
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watch 2 hrs more....prominent iscial spine is given to distract you....0 station is the ischial spine...fetus at +1 shows it crossses spine....if not after 2 hr.,do instrumentation
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| sherry39
Forum Junior
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it can be foreceps delievery
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| fandarast
Forum Junior
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The head is engaged already, so no CS is applicable. No reason to observe for 2 more hours, so I would go for A.
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| smalley
Forum Elite
Topics: 53
Posts: 291
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b low transverse c/s ..arrest in active phase due to prominent ischeal spine
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| guangyu
Forum Elite
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Posts: 308
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B.
can not use forcep for 3-8 dilatation
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