Induction of labor Quiz: Ace Your Exams
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A 36-year-old patient, gravida 3, para 2, presents at 39 weeks estimated gestational age (EGA) for an elective induction of labor. She has no contractions, loss of fluid, vaginal bleeding, or decreased fetal movement. The pregnancy was complicated by group B Streptococcus (GBS) bacteriuria in the first trimester and was treated with antibiotics in the first trimester. History is notable for two prior uncomplicated vaginal births at term. The patient takes no medication and has no allergies to medication. Vital signs are within normal limits. The abdomen is gravid and non-tender; the cervix is initially in a mid-position, soft, 1 cm dilated, 25% effaced, at –3 cm station. A non-stress test is reactive and reassuring. A dose of misoprostol is placed vaginally, and four hours later the cervix is still in a mid-position, 3 cm dilated, 50% effaced, and at –1 cm station. Which of the following is the most appropriate immediate step in management?
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