A vaginal exam for a laboring multipara client who is 42 weeks' gestation reveals the following information: 4 cm, minimal effacement, -2 station
Which clinical factors would affect the clinical management decision not to rupture membranes with an AmniHook?
a. Vaginal dilation
b. Client is a multipara
c. Presenting part is at –2 station
d. Gestational age
ANS: C
The fact that the presenting part is not engaged causes concern because there is increased risk of a prolapsed cord on artificial rupture of membranes (AROM). Vaginal dilation is adequate for attempt to rupture membranes. The fact that a client is a multipara is not a significant reason to affect clinical decision making with regard to AROM. Postdates of pregnancy may warrant a more aggressive approach to speed the labor and birth process.
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