What should be done first when encountering prolonged decelerations in fetal heart rate?

When encountering prolonged decelerations in fetal heart rate, the first priority is to maximize fetal oxygenation. Prolonged decelerations can indicate a concerning situation for the fetus, such as potential hypoxia or compromised blood flow, which can lead to serious outcomes. By focusing on maximizing fetal oxygenation, healthcare providers aim to ensure that the fetus receives adequate oxygen supply to minimize the risk of further complications.

Maximizing fetal oxygenation typically involves repositioning the mother to improve blood flow to the placenta, administering supplemental oxygen to the mother, ensuring adequate maternal hydration, and monitoring uterine contractions. These interventions are crucial in preventing fetal distress and improving the overall situation before further actions, such as notifying the obstetrician or preparing for delivery, are taken.

While assessing maternal hydration and notifying the obstetrician are important elements of managing prolonged decelerations, they are secondary to the immediate action of ensuring that the fetus can breathe adequately. Preparing for immediate delivery is a critical step that might follow if the situation does not improve after initiating oxygenation measures.