karusmle
Forum Guru
Topics: 296
Posts: 1,001
|
A 26-year-old primigravid woman at 35 weeks' gestation comes to the labor and delivery ward because of painful uterine contractions and a gush of fluid. Sterile speculum examination reveals a pool of clear fluid in the vagina that is nitrazine positive. When the fluid is examined under the microscope, a "ferning" pattern is seen. Cervical examination shows the patient to be 4 cm dilated, 100% effaced, and at 0 station. Fetal fingers can be felt along side the fetal head. External uterine monitoring shows contractions every 2 minutes. External fetal monitoring shows the fetal heart rate to be in the 130s and reactive. Which of the following is the most appropriate next step in management?
A. Expectant management
B. Oxytocin augmentation
C. Forceps delivery
D. Vacuum delivery
E. Cesarean section
|
| mesh
Forum Guru
Topics: 77
Posts: 401
|
A expectant management
|
| SilatK
Forum Guru
Topics: 42
Posts: 587
|
A I don't think they would go for E
___________________
To know is to not know..
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
B, A or E !
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
|
b BECAUSE the contraction is not frequent enough !
a may be the safe routine for the first 24 hours
e because the heart rate has dropped to 130 !
So let me think and I need some input !
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
|
| achilles
Forum Guru
Topics: 89
Posts: 1,224
|
A.
___________________
" it's not whether you get knocked down, it's whether you get up"
" i have miles to go before i sleep "
|
| drk1980
Forum Guru
Topics: 147
Posts: 1,038
|
agree
|
| drhyd
Forum Senior
Topics: 7
Posts: 82
|
Hi AAAAA
Contractions are at every two min, so they are enough.
Genreally contractions in labor are atleast for evry 5 min for 30 sec.
And fetal heart rate is 130 and reactive , so its not a bad sign to go for CS.
|
| drhyd
Forum Senior
Topics: 7
Posts: 82
|
Normal fetal heart rate is 110 to 160/min
|
| MAZI
Forum Elite
Topics: 8
Posts: 245
|
i think E
you say that we are waiting until the baby draw back his(her) hand !!!!!!!!!!!!!!
one one of the indication for cesarean is malpresentation that means anyfetal orientation otherthan cephalic
please send your explanation
|
| docofthebigapple
Forum Senior
Topics: 23
Posts: 182
|
A
http://www.fpnotebook.com/OB105.htm
|
| MAZI
Forum Elite
Topics: 8
Posts: 245
|
OK
THANK YOU
AND IF THE FOOT IS PRESENTED WITH CEPHAL, WHAT,S YOUR OPONION?
|
|
| |
| | | | | | | | | | | | |
