A 25-year-old G1P0000 presents to her obstetrician’s office for her first prenatal visit. She had a positive pregnancy test 6 weeks ago, and her last period was about two months ago, though at baseline her periods are irregular. Aside from some slight nausea in the mornings, she feels well. Which of the following measurements would provide the most accurate dating of this patient’s pregnancy?
ACrown-rump length
BFemur length
CAbdominal circumference
DBiparietal diameter
ESerum beta-hCG
A 26-year-old Caucasian G1 presents at 35 weeks gestation with mild vaginal bleeding. She reports no abdominal pain or uterine contractions. She received no prenatal care after 20 weeks gestation because she was traveling. Prior to the current pregnancy, she used oral contraception. At 22 years of age she underwent a cervical polypectomy. She has a 5 pack-year smoking history. The blood pressure is 115/70 mmHg, the heart rate is 88/min, the respiratory rate is 14/min, and the temperature is 36.7℃ (98℉). Abdominal palpation reveals no uterine tenderness or contractions. The fundus is palpable between the umbilicus and the xiphoid process. An ultrasound exam shows placental extension over the internal cervical os. Which of the following factors present in this patient is the risk factor for her condition?
AWhite race
BSmoking
CHistory of cervical polyp
DIntake of oral contraceptives
ENulliparity
A 36-year-old primigravid woman at 26 weeks' gestation comes to the physician complaining of absent fetal movements for the last 2 days. Pregnancy was confirmed by ultrasonography 14 weeks earlier. She has no vaginal bleeding or discharge. She has a history of type 1 diabetes mellitus controlled with insulin. Vital signs are all within the normal limits. Pelvic examination shows a soft, 2-cm long cervix in the midline with a cervical os measuring 3 cm and a uterus consistent in size with 24 weeks' gestation. Transvaginal ultrasonography shows a fetus with no cardiac activity. Which of the following is the most appropriate next step in management?
APlan for oxytocin administration
BPerform weekly pelvic ultrasound
CPerform dilation and curettage
DPerform cesarean delivery
EAdminister magnesium sulfate
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