A 28-year-old woman, gravida 2 para 1, at 35 weeks gestation comes to the office for evaluation of decreased fetal movement. Over
the past 12 hours, the patient has felt only 4 or 5 fetal movements. She rested for an hour and felt only 2 movements, prompting her
to come to the office. The patient has had no contractions, vaginal bleeding, or leakage of fluid. She has no chronic medical
conditions and has had no complications during this pregnancy The patient does not use tobacco, alcohol, or illicit drugs Blood
pressure is 136/84 mm Hg and pulse is 84/min. Fetal heart rate is 145/min on Doppler Fundal height is 35 cm and a slight fetal
movement is palpated through the abdominal wall. The remainder of the physical examination is unremarkable. Which of the
following is the best next step in management of this patient?
Q A Amniotic fluid index
Q B. Induction of labor
Q C. Nonstress test
Q D. Reassurance and routine visit in 1 week
Q E. Umbilical artery Doppler ultrasound
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