During labor augmentation with oxytocin, which finding indicates the infusion should be discontinued?

• A. The client needs to void.
• B. Amniotic membranes rupture.
• C. Uterine contractions occur every 8 to 10 minutes.
• D. The fetal heart rate is 180 bpm without variability.

Answer: (D)

Recognize signs of fetal distress during labor and understand how oxytocin can contribute to that distress. A fetal heart rate of 180 beats per minute with no variability is a dangerous pattern—tachycardia with absent variability suggests the fetus may be hypoxic or otherwise compromised. In the setting of labor augmentation, this is a cue that the ongoing oxytocin infusion could be worsening placental blood flow or stressing the fetus, so the infusion should be discontinued to remove the stimulus and reassess fetal status. After stopping, monitor the fetal heart tracing and maternal condition, and intervene as needed (reposition the mother, provide oxygen, ensure adequate IV fluids, and recheck contractions). The other scenarios described do not indicate fetal distress requiring stopping the infusion.