P.T.'s history reveals that she had one preterm delivery 4 years ago at 31 weeks' gestation. The infant girl
was in the neonatal intensive care unit (NICu) for 3 weeks and discharged without sequelae.
The second
preterm infant, a boy, was delivered 2 years ago at 35 weeks' gestation and spent 4 days in the hospital
before discharge. She has no other risk factors for preterm labor. Vital signs are normal. Her vaginal exam-
ination findings were essentially within normal limits: cervix long, closed, and thick; membranes intact.
Abdominal examination revealed that the abdomen was nontender, with fundal height at 29 cm, fetus in
a vertex presentation.
While you are waiting for laboratory results, what therapeutic measures do you consider?
• Maintain bed rest with bathroom privileges only.
• Hydration calms the uterus if there are mild contractions. Give her water to drink.
• Review external monitor strip, and assess for the presence of contractions. Notify the primary care
provider of patient's status.
• If labor ensues, discuss with obstetric and pediatric staff about transferring P.T. to a level 3 hospital,
which has an NICU.
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