A 24-year-old pregnant woman on her 37th week of pregnancy has been delivered to a maternity obstetric service with complaints of weak fetal movements. Fetal heartbeats are 95/min. On vaginal examination the uterine cervix is tilted backwards, 2 cm long, external orifice allows inserting a fingertip. Biophysical profile of the fetus equals 4 points. What tactics of pregnancy management should be chosen?

Answer options

1. Treatment of fetal distress, if ineffective, then elective cesarean section on the next day
2. Treatment of placental dysfunction and repeated analysis of the fetal biophysical profile on the next day
3. Urgent preparation of the uterine cervix for delivery
4. Urgent delivery via cesarean section
5. Doppler measurement of blood velocity in the umbilical artery

Explanation

The normal fetal heart rate (FHR) is 120 – 160 bpm. the FHR of the fetus in the question is 95 bpm, which is very low and indicative of fetal distress (fetal asphyxia) fetal biophysical profile (BPP) is a prenatal test used to check on a baby's Health (fetal asphyxia). The test combines fetal heart rate monitoring (nonstress test) and fetal ultrasound to evaluate a baby's heart rate, breathing, movements, muscle tone, and amniotic fluid level.