NCC Certified Electronic Fetal Monitoring (C-EFM) Practice Exam

What initial treatment should be administered for recurrent late decelerations with moderate variability during the first stage of labor?

1. Medication administration

2. Maternal repositioning

3. Supplemental oxygen

4. Increased fluid intake

The correct answer is: Maternal repositioning

Recurrent late decelerations with moderate variability during the first stage of labor often indicate a potential compromise in fetal oxygenation, typically related to uteroplacental insufficiency. In such cases, one of the first and most effective interventions is maternal repositioning. When the mother changes position, it can enhance uterine blood flow, improve placental perfusion, and increase the oxygen supply to the fetus, which may resolve or alleviate the decelerations. Position changes, such as moving the mother to a lateral position (preferably left side), can help relieve pressure on the umbilical cord and optimize blood flow to the placenta. This facilitates better fetal oxygenation and can positively influence fetal heart rate patterns. While medication, supplemental oxygen, and increased fluid intake have their roles in managing fetal heart rate abnormalities, the immediate and often most effective step to address late decelerations is repositioning the mother, making it the first line of action in this scenario.