A 26-year-old woman (gravida 3, para 2), whose only Papanicolaou (Pap) smear test was done five years ago and was normal, is admitted to hospital at 3

Subject
Obstetrics and Gynaecology
System
Pregnancy, Childbirth & Puerperium

Kathryn

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Jul 29, 2020
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A 26-year-old woman (gravida 3, para 2), whose only Papanicolaou (Pap) smear test was done five years ago and was normal, is admitted to hospital at 33 weeks of gestation, following an antepartum hoemorhage of 300ml. The bleeding has now ceased. Vital signs are as follows: Pulse 76/min, Blood pressure 120/80mmHg, Temperature 36.8°C, Fetal heart rate 144/min. The uterus is lax and nontender, the fundal height is 34cm above the pubic symphysis, and the presenting part is high and mobile. Apart from fetal monitoring with a cardiotocograph (CTG), which one of the following should be the immediate next step in management?
(A) Pelvic examination under anesthesia
(B) Performance of a Papanicolaou (Pap) smear
(C) Ultrasound examination of the uterus
(D) Induction of labour
(E) Immediate Caesarean section
 
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