Case 5: Ms. AR |
| Ms. AR is a 19 yo G1P0 at 39.5 weeks gestation
admitted for rupture of membranes. She presented 8 hours ago with a
nonspecific history complaining of pain and occassional contractions.
On history, she reports leaking some fluid over the last two or three
days. Her prenatal history is complicated by previous substance abuse
and she now is on Methadone maintenance (90 mg daily). She is Hepatitis
C positive. Her medical and surgical history is otherwise negative. Her
GBS status is unknown. On exam, she is grossly ruptured and the cervix is 2 cm dilated, 50% effaced, and the vertex is -3 station. She has no fundal tenderness at the time of admission. Her WBC is 14.6. Her temperature at admission is 98.9 degrees. She is admitted and started on Pitocin for augmentation of labor and Penicillin G secondary to suspected prolonged rupture of membranes. Currently, you are called to see her with the fetal tracing below. Her pulse is 118 bpm, her temperature is 100.6 degrees. She has fundal tenderness on exam. Below is her current tracing: |