QUESTION 32

 

A 35-year-old woman, gravida 1 para 0, at 35 weeks gestation comes to the office for evaluation of intermittent wetness of her
undergarments. The patient has experienced leakage of urine with laughing and coughing for the past 6 weeks, but the leakage has
been more frequent over the past 2 days Her prenatal course has otherwise been uneventful, and she is scheduled for routine group
B Streptococcus screening in 3 days. Temperature is 36.1 C (97 F), blood pressure is 120/80 mm Hg, and pulse is 76/min.
Examination shows a comfortable-appearing woman in no pain Sterile speculum examination shows a pool of nitrazine-positive clear
fluid in the vagina and a closed cervix. Ultrasound shows a fetus in vertex presentation and a low amniotic fluid index. The fetal heart
tracing is normal. Tocometry shows no contractions. Which of the following is the most appropriate next step in management of this
patient?
QA Amnioinfusion
0 B. Antibiotics
0 C. Expectant management
0 D. Pelvic floor muscle exercises
0 E. Pessary placement
0 F. Tocolysis
0 G. Urinalysis