If a fetal heart rate pattern shows decelerations after contractions, what is the initial intervention?

• A. Give 10 liters of oxygen via face mask.
• B. Prepare for cesarean.
• C. Continue monitoring.
• D. Obtain an oral maternal temperature.

Answer: (A)

Improving fetal oxygenation is the first step when decelerations occur after contractions, suggesting possible uteroplacental insufficiency. Administering high-flow oxygen to the mother increases the amount of oxygen in her blood, which crosses to the fetus and can help lessen hypoxia that contributes to these decelerations. This direct action on the oxygen supply makes it the most immediate and impactful intervention among the options. While repositioning the mother, stopping oxytocin, or preparing for cesarean may also be part of subsequent management if the pattern persists, giving oxygen right away addresses the likely problem of reduced fetal oxygen delivery. Checking the maternal temperature, while important for infection if other signs appear, does not address the acute fetal oxygenation issue in this scenario.