Fetal decelaration at labor, what to do next? - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 07-22-2011
aksyonez's Avatar
USMLE Forums Veteran
 
Steps History: 1+CK+CS
Posts: 218
Threads: 74
Thanked 116 Times in 64 Posts
Reputation: 128
ObGyn Fetal decelaration at labor, what to do next?

A 30 y/o obese G3P2 woman is in active labor at 41 weeks gestation. She has no significant past medical history and had an uncomplicated pregnancy with appropriate prenatal evaluation. The patient ruptured membranes spontaneously 30 mn ago. Contractions occur regularly every 2-3 mn. Early decelerations are noted on fetal heart rate monitor with each of the past five contractions. Which is the most appropriate next step in management?

A. Change the maternal position
B. No further management is required
C. Place a fetal scalp probe
D. Prepare for emergent c-section
E. Start aminoinfusion of saline
Reply With Quote Quick reply to this message
The above post was thanked by:
dr.tasneem (07-24-2011)



  #2  
Old 07-22-2011
Kais_MD's Avatar
USMLE Forums Veteran
 
Steps History: 1+CK+CS
Posts: 299
Threads: 26
Thanked 177 Times in 103 Posts
Reputation: 187
Default

change maternal Position...early decelarations are fetal head compressions...Hopefully i am right about the mgmnt
Reply With Quote Quick reply to this message
  #3  
Old 07-22-2011
Ace3's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 735
Threads: 89
Thanked 289 Times in 191 Posts
Reputation: 301
Default

I think change in position is the answer to left lateral position which compress IVC and increase cardiac output and hence more supply to foetus........so its A.............
Reply With Quote Quick reply to this message
 
  #4  
Old 07-22-2011
busterbee's Avatar
USMLE Forums Veteran
 
Steps History: 1 + CK
Posts: 218
Threads: 16
Thanked 110 Times in 59 Posts
Reputation: 120
Default

i'l go with B
Reply With Quote Quick reply to this message
  #5  
Old 07-23-2011
aksyonez's Avatar
USMLE Forums Veteran
 
Steps History: 1+CK+CS
Posts: 218
Threads: 74
Thanked 116 Times in 64 Posts
Reputation: 128
Default

The correct answer is B. Early deccelarations are shallow, symmetric deccelarations in which the nadir of the deccelaration is coincident with the peak of the uterine contraction. They are mediated by vagal stimulation due to fetal head compression from the contracting uterus and thus indicate a normally functioning fetal autonomic nervous system. They are not associated with fetal hypoxia, acidosis, or poor neonatal outcome. No further management is necessary.
Reply With Quote Quick reply to this message
The above post was thanked by:
MerryM (11-04-2016)
  #6  
Old 07-24-2011
dr.tasneem's Avatar
USMLE Forums Scout
 
Steps History: Not yet
Posts: 29
Threads: 0
Thanked 7 Times in 6 Posts
Reputation: 17
Correct Answer BBBB

the answer is B because early decelaration are due to head compression as it pass through the birth canal.....
Reply With Quote Quick reply to this message
  #7  
Old 07-24-2011
USMLE-Syndrome's Avatar
USMLE Forums Master
 
Steps History: ---
Posts: 1,203
Threads: 180
Thanked 1,254 Times in 441 Posts
Reputation: 1268
Default

B. No further management is required
early declaration cause by fetal head compression
it is normal
Reply With Quote Quick reply to this message



Reply

Tags
ObGyn-, Step-2-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Amniotomy + Bleeding + Fetal bradycardia Sabio USMLE Step 2 CK Classic Clues 6 05-05-2016 09:12 AM
A virus that caused enlarged fetal heart! ricko335 USMLE Step 1 Forum 10 07-21-2011 12:34 PM
Fetal Heart Beats could not be heard! aksyonez USMLE Step 2 CK Forum 5 07-02-2011 06:28 PM
Fetal gut rotation aktorque USMLE Step 1 Forum 13 04-05-2011 12:43 AM
Earliest Detection of Fetal Heartbeats khushboo USMLE Step 1 Forum 6 05-29-2010 10:04 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)