Question

A partogram of a woman who is in labor is shown below. Oxytocin infusion is already given. How will you manage the condition?

• A. Forceps-assisted delivery
• B. Vacuum-assisted delivery
• C. Oxytocin infusion
• D. Cesarean section

Answer 1

The Correct Option is D

In the given scenario, the woman is in labor and is already receiving oxytocin infusion. Based on the information provided, it is important to assess the progression of labor and decide the next step in management.
1. Assessment of the Partogram: A partogram is a graphical record of the observations made on a woman in labor. It typically tracks the cervical dilation over time. If the partogram shows that labor is not progressing despite oxytocin infusion, alternative management strategies should be considered.
2. Understanding the Options: Given that oxytocin infusion is already in use, the potential next steps for management include instrumental delivery (such as forceps or vacuum-assisted delivery) or surgical intervention (cesarean section).

• Forceps-assisted Delivery: This may be considered if the labor is in the second stage, provided that the cervix is fully dilated, and the fetal head is low in the pelvic cavity.
• Vacuum-assisted Delivery: Similar to forceps delivery, suitable for the second stage of labor with a fully dilated cervix.
• Cesarean Section: Indicated if labor is not progressing, and instrumental delivery is either not possible or not safe, or if the fetal condition is deteriorating.

3. Decision-making: Since oxytocin infusion is already being administered, and if the partogram indicates failure to progress after adequate trial with oxytocin, a cesarean section is the most appropriate next step to ensure the safety of both the mother and the fetus. The correct course of action is therefore to proceed with a Cesarean section.