If electronic fetal monitoring shows recurrent late decelerations and reduced variability, what is the immediate priority?

• A. Stop oxytocin if infusing, reposition the mother, notify provider, and prepare for possible delivery (may need cesarean)
• B. Increase oxytocin infusion
• C. Apply tocolytics
• D. Administer IV fluids and vitamins

Answer: (A)

When fetal monitoring shows late decelerations with reduced variability, the fetus is likely experiencing uteroplacental insufficiency and hypoxia. The immediate goal is to restore and optimize oxygen delivery and be ready for delivery if the fetus cannot be stabilized. Stop any oxytocin infusion to lessen uterine contractions and placental stress, and reposition the mother to improve uteroplacental blood flow (often to the left side). Notify the obstetric provider urgently so rapid decisions about delivery can be made. Prepare for possible delivery, including cesarean, if the nonreassuring pattern persists or worsens.

Increasing oxytocin would worsen placental perfusion and fetal distress. Tocolytics might delay labor but do not address the underlying oxygenation issue in this scenario. Administering IV fluids and vitamins alone does not resolve the fetus’s distress and is not the immediate priority.