What is the recommended action for managing late decelerations during labor?

Late decelerations during labor are indicative of fetal distress, often due to uteroplacental insufficiency, which can lead to decreased oxygen supply to the fetus. The primary goal in managing this situation is to improve placental blood flow and fetal oxygenation.

Administering Terbutaline is appropriate as it is a tocolytic agent that helps to relax uterine contractions. By relaxing the uterus, Terbutaline can decrease the pressure on the umbilical cord and improve blood flow, thereby addressing the factors contributing to late decelerations. This intervention may stabilize the fetal heart rate and help ensure the fetus is receiving adequate oxygen.

In contrast, increasing contraction intensity would likely exacerbate the problem by further reducing blood flow to the fetus. While repositioning the mother to the left side can help improve venous return and increase blood flow to the placenta, it does not directly address uterine hypertonicity, which Terbutaline can manage. Performing an episiotomy is not indicated in this situation, as it does not relate to managing the late decelerations and could pose unnecessary risks. Therefore, administering Terbutaline is the most effective and appropriate action in this context.