rei
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24 year old primigravida lady with acute onset of irregular uterine contraction at 35 weeks of gestation. there is heavy show without leakage of liquor
A. there is a possibility of antepartum hemorrhage
B. digital vaginal examin should be done right away
C. induction of labour should be started immediately
D. if there is uterine contration, tocolytic treatment can be admin.
E. if there is no labour, C/S should be perfomred within 24 hours
which one is correct?
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| nany
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D
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| Ivonne
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where did you get your question from? I hope C/S means C section. What is heavy show---->is it blood?, liquor------->amniotic fluid? If somehow i understood the terminoogy i will go for antepartum hemorrhage, but not sure, terminology is confusing...
Nany, what is heavy show??????????????
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| rei
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sorry for the confusion
ur right, ivonne 
C/S = C section
heavy show = discharge from vagina of mucus with blood streak
liquor = amniotic fluid
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| Ivonne
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Ok thaks rei. Ok everything changes. I need to know if the patient is truly in pre-term labor or is it is false labor, the only way to do it is evaluate cervical changes by digital exam so i will go with B.
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| nany
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do you evaluate cervical changes with digital exam. or with sterile speculum exam. Ivonne?
I think he means bloody show....which is a mucus plug streaked with blood expelled out with starting of cervical dilatation
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| Ivonne
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Love to know that we are in the same page nany and specially because we are going to learn about this.
Regarding your question i think we can do both. First sterile speculum to rule out PPROM(In this case seems that it is already ruled out) then digital exam. Agree it is bloody show but it is not a criteria of preterm labor which is:
<37 weeks and:
- Regular uterine contractions >3, lasting 30 seconds over a period of 30 minutes and
- Documented cervical changes or cervical effacement of 80% and dilatation of 2 cm or more.
treatment
First step----------> Bed rest and hydration if persists:
Second step------->Tocolysis if no contraindications
I think this patient is having false labor but need to measure...
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| nany
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nice explaination Ivonne 
me too happy for that, and dicussion is always helpfull ..., especially with 99 member like you  
I feel that this question has very very little information
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| Ivonne
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hey nany don't make fun of me
rei don't forget to post your answer to make the question useful. Thanks
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| nany
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I will never make fun of you Ivonne ...I have confidence in you much more than you think
and yes rei...please post the answer if you have it
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| rei
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ans: a
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| nany
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it's ( A ) Ivonne  ........make sense 
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