Question

A 19-year-old G1 woman at 28 weeks gestation comes to labor and delivery because of the onset of contractions. The patient describes the contractions as progressively becoming more painful, each lasting 40 seconds and now occurring every five minutes. She reports good fetal movement and does not have any bleeding or leakage of fluid. On evaluation in triage, it is noted that she is having regular contractions, approximately every five minutes, has intact membranes and her cervical exam is 3 cm dilated and 50% effaced. What is the most frequent cause of this condition?

A. Dehydration
B. Fetal anomalies
C. Idiopathic
D. Uterine fibroids
E. Cervical incompetence

Answer 1

The most frequent cause of preterm labor in a 19-year-old woman at 28 weeks gestation with regular contractions and 3 cm dilated and 50% effaced cervix is typically idiopathic, which means the cause is unknown.

Step-by-step explanation:

The most frequent cause of the condition described, where a 19-year-old woman at 28 weeks gestation is having regular contractions with cervical dilation of 3 cm and effacement of 50%, is often idiopathic, which means it has no identifiable cause. However, other potential causes to consider include dehydration, uterine fibroids, and cervical incompetence.

True labor involves a positive feedback loop of uterine contractions that stretch the cervix, leading to further dilation and effacement. This process leads to increased secretion of oxytocin from the pituitary gland, which then triggers stronger uterine contractions, causing more significant cervical changes.

Since the patient does not present with symptoms such as bleeding, leakage of fluid, fetal anomalies, or a history indicating cervical incompetence, and given no other specific cause has been mentioned, the most likely cause of her preterm labor is idiopathic.