Ineffective Expulsive Efforts in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#13334
SMLE Question #13334
Obstetrics & Gynecology
General Gynecology
Objective: OBJ-ETH-STERIL
Last updated: February 2026
A 27-year-old primigravida at 40 weeks is in the second stage of labor. She has been pushing for 2 hours and is now exhausted with ineffective expulsive efforts. The cervix is fully dilated, membranes are ruptured, and the fetal head is cephalic at +2 station with an adequate pelvis on examination. Continuous fetal heart rate monitoring shows minimal variability with recurrent late decelerations. What is the most appropriate next step in management?
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