Final answer:
In the case of a 23-year-old woman at term in early labor, the best course of action is to perform continued fetal surveillance and reexamine in two hours. Cesarean section or other interventions should only be considered after allowing sufficient time for natural labor progression, taking into account all three stages of labor and the option of oxytocin augmentation if necessary.
Step-by-step explanation:
Labor and Delivery Management
A 23-year-old G1P0 woman presenting to labor and delivery at 40 weeks gestation with contractions and 2 centimeters cervical dilation requires careful assessment and management. At this stage, the recommended action would be to continue fetal surveillance and reexamine the patient in two hours. This approach is justified because labor involves three stages: the dilation of the cervix, the expulsion of the baby, and the passage of the placenta. Induction of labor using synthetic oxytocin (Pitocin) may be considered if labor stalls before reaching stage two, to restart and maintain contractions.
Given that the patient is at term and has just begun labor, it is premature to consider Cesarean section due to failure to progress without giving adequate time for labor to advance naturally. A biophysical profile would be considered if there were concerns about fetal well-being. In this scenario, patient ambulation can also be beneficial as it may help in progressing labor. If labor fails to progress with these measures, oxytocin augmentation can be a subsequent step after reevaluation.