Primigravida at term with no palpable presenting part - USMLE Forums
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  #1  
Old 10-08-2011
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ObGyn Primigravida at term with no palpable presenting part

25 years old primigravida, at term, regular adequate intensity uterine contractions, at 7 cm dilation. No presenting part can be palpated through the bulging membranes. What the best next step in the management?

A) Observation until full effacement & dilation of the cervix.
B) IV oxytocin.
C) Sonogram.
D) Consider forceps/ VE.
E) C section.
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  #2  
Old 10-09-2011
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Consider forceps/ VE.
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  #3  
Old 10-09-2011
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i think , sonogram
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Old 10-09-2011
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Post observation...

i think while every thing is ok ... no fetal or maternal distress and regular effective contractions ......i'll go for observation untill full dilatation.....
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Old 10-09-2011
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Observation until full effacement & dilation of the cervix.
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Old 10-09-2011
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Well... ...ultrasound would be the ideal measure ALWAYS and before anything.
I would program a c section...not as emergency....but as urgency. Only multiparas can change fetal positions even minutos before the expulsive phase. According to the American style...maybe they expect we indicate an ultrasound..
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Old 10-09-2011
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The correct answer: C) Sonogram.
As we can see she is in stage 1 active, we need to know the presenting part & the lie.
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