A pregnant lady with persistent late, variable deceleration with cervical dilatation of 6 cm shifted to OT for surgery. Which of the following is not done in Mmn:
(A) Supine position (B) O2 inhalation (C) I.V. fluid (D) Subcutaneous terbutaline
(A) “Deceleration is defined as a decrease in fetal heart rate below the base line of 15 beats per minute or more.”
Variable deceleration is seen in case of cord-compression/prolapse. In case of cord-compression/prolapse patient should not be allowed to rest in supine position as it will lead to more pressure on the cord. In cord prolapse the patient is allowed to rest in exaggerated elevated Sims position with a pillow under the hip.
Management of Non-reassuring fetal status (Fetal Distress)

Lateral positioning avoids compression of vena cava and aorta by the gravid uterus. This increases cardiac output and uteroplacental perfusion.
Oxygen is administered to the mother with mask to improve fetal SaO2.
Correction of dehydration by IV fluids (crystalloids) improves intravascular volume and uterine perfusion.
Correction of maternal hypotension (following epidural analgesia) with immediate infusion of 1 litre of Crystalloid (Ringer’s solution).
Stoppage of oxytocin to improve fetal oxygenation. Fetal hypoxia may be due to strong and sustained uterine contractions. With reassuring FHR and in absence of fetal acidemia, oxytocin may be restarted.
Tocolytic (Injection terbutaline 0.25 mg S.C.) is given when uterus is hypertonic and there is nonreassuring FHR.
Amnioinfusion is the process to increase the intrauterine fluid volume with warm normal saline (500 ml). Indications are:

– Oligohydramnios and cord compression
– To dilute or to wash out meconium
– To improve variable or prolonged decelerations.
Advantages : Reduces cord compression, meconium aspiration, and improves Apgar score.