During an oxytocin infusion for labor, contractions exceeding five in 10 minutes, what is the first action?

• A. Stop the infusion
• B. Place in left lateral position
• C. IV bolus
• D. Administer terbutaline

Answer: (A)

Excessive contractions during labor signal tachysystole from the oxytocin infusion, which can reduce placental blood flow and endanger the fetus. The first action is to stop the oxytocin infusion. This directly removes the stimulus driving the high-frequency contractions, giving the uterus a chance to relax and improve uteroplacental perfusion. After stopping the infusion, reassess the fetal heart rate and maternal status. If contractions remain excessive or the fetal tracing is nonreassuring, subsequent steps may include repositioning the mother to a left lateral position to improve blood flow and giving IV fluids to support circulation; if contractions stay high and fetal distress persists, a tocolytic like terbutaline may be used.