Answer the USMLE (Step 3) question(s) below, choose one answer from the multiple choices, and then get the answer by clicking on the “get answer” button.
Question
You are driving to the hospital to evaluate one of your obstetric patients who called and said that she was contracting every 7 minutes. She says that she has no vaginal discharge but has been feeling “lots of fetal movement”. You remember that she is a G2P1001 woman at 38 weeks’ gestation. She was unsure of her last menstrual period, so a first trimester ultrasound was done to establish her due date. There were no abnormalities seen at the time of the ultrasound. Upon arriving on labor and delivery, you learn that on the way to the hospital the patient’s car rear/ended another car at low speed. She was a belted passenger. She has developed moderate vaginal bleeding and more severe contractions that are now occurring “one on top of the other”. Her abdomen is tender with a reddened area from her lap belt. Her temperature is 37 C (98.6 F), blood pressure is 90/60 mm Hg, pulse is 110/min, and respirations are 22/min. The fetal heart rate is being monitored and the baseline is 180/min. Uterine contractions are occurring every 60 seconds and are lasting 45 seconds. At this time you should
A. Administer betamethasone
B. Give magnesium sulfate for tocolysis
C. Manage the labor expectantly
D. Prepare for a cesarean section while stabilizing the patient
E. Order an ultrasound to rule out placenta previa
