USMLE Question of the Week

Peripartum Management for Fetal and Maternal Safety

In Episode 56 of Med School Question of the Week for USMLE, Faustine Ramirez, MedSchoolCoach expert tutor, answers this medical school question: A 26-year-old gravida 2, para 1 woman at 37 weeks and 2 days gestation is admitted to the hospital in labor. She had spontaneous rupture of membranes 4 hours ago. Contractions are moderately painful and occur every 4 to 5 minutes. She received routine prenatal care and has had no problems during the current pregnancy. Her blood type is O positive, and the father’s blood type is AB negative. Prenatal labs were all unremarkable. She has no past medical history and takes no medications. Her previous pregnancy was uneventful but her older child was treated for GBS meningitis in the first week of life. Her temperature is 37.5 C, heart rate is 85/min, respiratory rate is 17/min, and blood pressure is 124/72. The cervix is 5 cm dilated and 70% effaced, and fetal monitoring demonstrates a category I fetal heart tracing. Which of the following is indicated at this time?
  • Urgent cesarean section
  • Betamethasone
  • Tertbutaline
  • Rhogam
  • Penicillin
  • Misoprostol
  • Magnesium sulfate
  • No interventions are indicated
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Faustine Ramirez

Faustine graduated from the University of Washington in Seattle with a B.A. in Medical Anthropology and Global Health. She attends medical school at University of California, San Francisco where she designed and taught a course on clinical reasoning skills, developed curriculum materials for the pre-clinical pediatrics course, and led case-based sessions in pediatrics and infectious disease. She received a 253 on Step 1 and a 266 on Step 2 CK, and she scored in the 90th percentiles on all of her shelf exams.

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