A healthy 18-year-old patient who is 40 weeks' gestation presents at the clinic complaining of vaginal expulsion of stringy mucus followed by blood-tinged secretions. She denies any discomfort or any other changes
Based upon the patient's complaints, what is most likely to occur within the next 24 to 48 hours?
1. Onset of labor
2. Spontaneous abortion
3. Cesarean section
4. Chorioamnionitis
Correct Answer: 1
Rationale 1: Softening and effacement of the cervix is accompanied by expulsion of the mucous plug and a small amount of blood loss from the exposed cervical capillaries. The resulting pink-tinged secretions are called bloody show. Bloody show is considered a sign that labor will begin within 24 to 48 hours.
Rationale 2: The patient is most likely demonstrating expulsion of the mucous plug and bloody show, which is considered a sign that labor will begin within 24 to 48 hours.
Rationale 3: The patient is describing pregnancy-related changes associated with imminent onset of labor. Based upon her report, there is no indication that cesarean section will be necessary.
Rationale 4: Chorioamnionitis is associated with premature rupture of amniotic membranes (PROM). Based upon the patient's report, she is demonstrating mucus plug expulsion and bloody show.
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