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A 19yo woman who is 33 weeks pregnant presents with contractions every 2 minutes and thinks her water broke. She has no prenatal care records available, and was only recently diagnosed as pregnant at an outside clinic. On exam, she is 9cm dilated and +1 station. She is screaming with pain.
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July 10, 2018 at 8:30 pm
A) Indomethacin 50 mg PO for tocolysis.
The patient has presented in acute preterm labor, defined as cervical dilation > 3cm or cervical length 32 weeks gestation due to its potential effects on the ductus arteriosus. Magnesium is neuroprotective for the fetus; ampicillin or penicillin should be given if GBS status is unknown; opiate pain medications are appropriate to give although providers must be ready to resuscitate the baby if respiratory status is affected.