A woman who is 42 weeks pregnant comes to the clinic. Which of the following would be most important?
A) Determining an accurate gestational age
B) Asking her about the occurrence of contractions
C) Checking for spontaneous rupture of membranes
D) Measuring the height of the fundus
A
Feedback:
Incorrect dates account for the majority of prolonged or postterm pregnancies; many women have irregular menses and thus cannot identify the date of their last menstrual period accurately. Therefore, accurate gestational dating via ultrasound is essential. Asking about contractions and checking for ruptured membranes, although important assessments, would be done once the gestational age is confirmed. Measuring the height of the fundus would be unreliable because after 36 weeks, the fundal height drops due to lightening and may no longer correlate with gestational weeks.
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