A 39-year-old woman, gravida 3 para 2, comes to the emergency department at 37 weeks

Medicoman · March 21, 2020, 5:28am

A 39-year-old woman, gravida 3 para 2, comes to the emergency department at 37 weeks gestation due to leakage of fluid for the last

2 hours. She has also had some vaginal bleeding and contractions for the last hour. Fetal movement is normal. The patient

immigrated to the United States 6 months ago and has had no prenatal care this pregnancy Her previous pregnancies were

uncompl icated and delivered vaginally at term. Blood pressure is 100/60 mm Hg, pulse is 102/min, and respirations are 16/min. On

speculum examination, rupture of membranes is confirmed and the patient has some small blood clots at the cervical os. An

ultrasound reveals an active fetus in cephalic presentation whose growth is consistent with gestational age and placental tissue

covering the cervix. Fetal heart rate baseline is 150/min with accelerations and no decelerations. Tocodynamometry shows

contractions every 3 minutes. Which of the following is the most appropriate next step in management of this patient?

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