This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Obstetrics, Subject name: Gynaecology & Obstetrics
A 26-year old primipara at term gestation with labour pains presents with cervical dilation 3 cm, 60% effacement, Meconium stained liquor & decreased fetal hea rate: management is... 
Select and explain. 
A. Oxytocin drip to accelerate labour pains, B. IV drotaverine to improve cervical dilatation, C. Attempt a Vaccum delivery, D. Sta oxygen and shift to OT for emergency LSCS
D: Sta oxygen and shift to OT for emergency LSCS
Answer: D: Sta oxygen and shift to OT for emergency LSCS 
Explanation: Fetal hea rate lesser than 110 is fetal distress and after the initial resuscitation the best management is Cesarean section. Fetal distress is the commonest cause of Cesarean section in modern obstetrics. Also, 'meconium in the liquor' indicates present or recent fetal strain. If the fetal hea rate is reassuring and patient is likely to deliver soon, then we can do amnio-infusion to dilute the meconium in the liqour with strict fetal monitoring and expedite delivery. Here since the patient is only 3 cm dilated and delivery is not imminent, it is advisable to perform an emergency LSCS, this reduces the chances of 'Meconium aspiration syndrome " of the new born which can lead to pnemonitis in the fetus and secondarily hypoxic injury to the brain.