QUESTION 14

 

A 41-year-old woman, gravida 2 para 1, at 35 weeks gestation comes to the emergency department with uterine contractions that
started approximately 6 hours ago after a trip to the beach. The patient feels 3-5 contractions every hour. She has been managed
with weekly injections of hydroxyprogesterone for a history of a vaginal delivery after presenting in spontaneous preterm labor at 34
weeks gestation. Two days ago, the patient had a routine recto-vaginal culture that was positive for group B Streptococcus. Blood
pressure is 110/80 mm Hg and pulse is 92/min. Digital cervical examination shows the cervix to be closed. Bedside ultrasound shows
an estimated fetal weight consistent with 35 weeks gestation and a vertex presentation. The fetal heart tracing is normal and
tocometry shows irregular uterine contractions. Which of the following is the most appropriate next step in management of this
patient?
QA Administer betamethasone
0 B. Administer indomethacin
0 C. Administer magnesium sulfate
0 D. Administer penicillin
0 E. Measure cervical length by ultrasound
0 F. Reassure patient and discharge home