Induction of labor Quiz: Ace Your Exams
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A 26-year-old woman, gravida 2, para 1, at 39 weeks of estimated gestational age (EGA), presents after a large gush of fluid passed from the patient’s vagina one hour ago. She has continued to leak clear fluid since that time, but has no contractions, vaginal bleeding, or decreased fetal movement. Her first delivery was a full-term birth 2 years ago. She also has a history of herpes simplex virus (HSV), type 2, managed with prophylactic valacyclovir. Records show that routine antenatal screenings, including a pap test for this pregnancy, have all been normal. Temperature is 36.5°C (97.8°F), pulse is 78/min, respirations are 18/min, and blood pressure is 115/70 mmHg. On exam, the abdomen is gravid and non-tender. A pelvic exam shows gross pooling of clear fluid on the speculum, and the cervix is visually dilated 3 cm. A non-stress test (NST) has a baseline of 150/min, moderate variability, 2 accelerations, and no contractions. Which of the following clinical findings would be a contraindication to induction of labor?
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