A 32-year-old woman, gravida 3 para 2, at 35 weeks gestation comes to the hospital due to frequent painful uterine contractions. The
patient was hospitalized at 24 weeks gestation for a shortened cervix diagnosed during an anatomy ultrasound and a positive fetal
fibronectin test During her hospitalization, she received a course of betamethasone and was discharged after 2 days of observation.
Vaginal progesterone was prescribed, but the patient was not compliant with use as it was “too messy” Her prior pregnancies ended
in term vaginal deliveries. The patient’s blood pressure is 120/70 mm Hg and pulse is 80/min. Digital examination shows that the
cervix is 4 cm dilated and 90% effaced with the fetus at -1 station. The tocodynamometer shows contractions every 6 minutes.
Ultrasound reveals that the fetus is in breech presentation Which of the following is the most appropriate next step in management of
this patient?
- QA Administration of indomethacin
- 0 B. Administration of magnesium sulfate
- 0 C. Administration of nifedipine
- 0 D. Cesarean delivery
- 0 E. Expectant management
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