Question:
A 30-year-old G2P1 woman presents in labor. She has a previous cesarean, active labor, fetal bradycardia, maternal tachycardia, and cervix 8 cm dilated. What is the next step?
A 30-year-old G2P1 woman presents in labor. She has a previous cesarean, active labor, fetal bradycardia, maternal tachycardia, and cervix 8 cm dilated. What is the next step?
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Previous cesarean with fetal bradycardia during labor = suspect scar rupture and do emergency C-section.
Updated On: Aug 27, 2026
- Instrumental delivery
- ARM
- Increase oxytocin dose
- Emergency Cesarean section
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The Correct Option is D
Solution and Explanation
Concept:
In a woman with previous cesarean section, fetal bradycardia and maternal tachycardia during labor may suggest uterine rupture or impending rupture. This is an obstetric emergency.
Step 1: Identify the risk factor.
Previous cesarean section is a major risk factor for uterine scar rupture during labor.
Step 2: Identify danger signs.
The warning signs include: \[ \text{Fetal bradycardia + maternal tachycardia} \] These indicate fetal distress and possible uterine rupture.
Step 3: Choose immediate management.
Since the cervix is only 8 cm dilated and there is fetal distress, instrumental delivery is not appropriate. The next step is: \[ \text{Emergency Cesarean section} \] Therefore, the correct answer is Emergency Cesarean section.
Step 1: Identify the risk factor.
Previous cesarean section is a major risk factor for uterine scar rupture during labor.
Step 2: Identify danger signs.
The warning signs include: \[ \text{Fetal bradycardia + maternal tachycardia} \] These indicate fetal distress and possible uterine rupture.
Step 3: Choose immediate management.
Since the cervix is only 8 cm dilated and there is fetal distress, instrumental delivery is not appropriate. The next step is: \[ \text{Emergency Cesarean section} \] Therefore, the correct answer is Emergency Cesarean section.
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