Question

A 20-year-old G1P0 woman at 28 weeks gestation presents to triage with uterine contractions every four minutes. On exam, her cervix is long, closed and posterior. Her urinalysis is normal. Fetal fibronectin is negative. In addition to hydration, which of the following is the most appropriate next step in the management of this patient?

A. Administer betamethasone
B. Expectant management
C. Bedrest
D. Tocolysis
E. Cerclage

Answer 1

Expectant management is the appropriate next step for a pregnant woman at 28 weeks gestation with uterine contractions and a negative fetal fibronectin test since the cervix is closed, and there's a low risk of preterm delivery.

Step-by-step explanation:

The most appropriate next step in the management of a 20-year-old G1P0 woman at 28 weeks gestation who presents with uterine contractions every four minutes but has a long, closed, and posterior cervix with a negative fetal fibronectin test is Expectant management. Given that the cervix is not opening and there are no other indicators of preterm labor, the negative fetal fibronectin suggests that the risk of preterm delivery within the next week is low. Expectant management includes observation and continued evaluation for signs of labor progression. Interventions such as administering betamethasone, bedrest, tocolysis, or cerclage are not indicated at this time due to the absence of signs of progressive labor.