A 25-year-old primigravida at 38 weeks of gestation is being monitored in the Labor and Delivery Ward. Abdominal examination reveals an average size fetus of 3 kg in cephalic prese... A 25-year-old primigravida at 38 weeks of gestation is being monitored in the Labor and Delivery Ward. Abdominal examination reveals an average size fetus of 3 kg in cephalic presentation and well engaged head. Cervical examination shows 5 cm dilated, 70% effaced and -3 station for the last 4 hours. She is not distressed and not on epidural analgesia. Fetal monitoring is done. Which of the following is the best next step of management? A. Start MgSO4 B. Start Oxytocin C. Cesarean section D. Reassess in 2 hours Read more

Understand the Problem

The question is asking for the best next step of management for a pregnant woman in labor based on her current clinical status. We need to analyze her dilation progress, fetal position, and overall condition to determine the most appropriate intervention.

More Information

In this scenario, the patient is in active labor with a well-engaged fetal head, 5 cm cervical dilation, and no distress signs, suggesting no immediate complications. Starting oxytocin can help augment labor since there has been no progression for 4 hours.

Tips

A common mistake is opting for a Cesarean section prematurely without trying other options like oxytocin to stimulate labor. Always ensure there is no fetal distress or other contraindications for oxytocin use.

Sources

• Induction of labour at or beyond 37 weeks' gestation - PubMed Central - pmc.ncbi.nlm.nih.gov