A woman, aged 40, primigravida, with infertility in the medical history, on the 42–43 week of pregnancy. Labour activity is weak. Longitudinal presentation of the fetus, I position, anterior position. The head of the fetus is engaged to pelvic inlet. Fetus heart rate is 140 bmp, rhythmic, muffled. Cervix dilation is 4 cm. On amnioscopy: greenish colour of amniotic fluid and fetal membranes. Cranial bones are dense, cranial sutures and small fontanel are diminished. What should be tactics of delivery?

Answer options

1. Amniotomy, labour stimulation, fetal hypoxia treatment
2. Fetal hypoxia treatment, conservative delivery
3. Fetal hypoxia treatment, in the ІІ period – forceps delivery
4. Caesarean section
5. Medication sleep, amniotomy, labour stimulation

Explanation

A woman, aged 40, primigravida, with infertility in the medical history, on the 42-43 week of pregnancy. Labour activity is weak. Longitudinal presentation of the fetus, I position, anterior position. The head of the fetus is engaged to pelvic inlet. Fetus heart rate is 140 bmp, rhythmic, muffled. Cervix dilation is 4 cm. On amnioscopy: greenish colour of amniotic fluid and fetal membranes. Cranial bones are dense, cranial sutures and small fontanel are diminished. What should be tactics of delivery A. Caesarean section → Before the child aspirates and goes into distress B. Amniotomy, labour stimulation, fetal hypoxia treatment C. Fetal hypoxia treatment, in the II period – forceps delivery → Cervix is not dilated D. Fetal hypoxia treatment, conservative delivery E. Therapeutic rest, amniotomy, labour stimulation