FCOG-1062

A 27-year-old primigravida female presents to the emergency department at full term.

6 hours ago, she spontaneously began labour. The membranes ruptured two hours ago and the liquor was stained with meconium.

On cardiotocography (CTG) was conducted and it showed some intermittent late decelerations, from 140 to 110 beats/min.

On vaginal examination, her cervix id 5 cm dilated. The foetus is in cephalic presentation, in the left occipitotransverse (LOT) position, with the bony head at the level of the ischial spines (IS).

Due to the deceleration pattern, a fetal scalp pH estimation was performed and the pH was measured at 7.32.

An hour later, the CTG showed the following pattern over a period of 30 minutes:

Baseline 140/min
Baseline variability 1/min
Accelerations None evident
Decelerations Two decelerations were evident, with the heart rate falling to 80/min, and with each lasting 4 minutes

Another vaginal examination is conducted and her cervix is now 8cm dilated, but otherwise unchanged from one hour previously.

What would be the next best line management?