50 Obstetrics and Gynecology Board Review •••
❍ What maneuvers should be performed for intrauterine resuscitation with late decelerations?
Administer oxygen via face mask.
Change maternal position to lateral decubitus to minimize supine hypotension and improve uterine blood flow.
Correct hypotension if present.
Stop oxytocin infusion.
Consider terbutaline, especially in presence of uterine hyperstimulation.
Validate fetal well-being with scalp stimulation.
❍ What is the mechanism of supine hypotension?
Uterine compression of the inferior vena cava leads to decreased return of blood to the heart (preload), decreasing
maternal cardiac output, causing maternal hypotension and decreased uterine blood flow.
❍ What does this fetal heat rate monitoring tracing represent?
Late deceleration.