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28.4: Chapter 18

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    104881
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    Unfolding Case Study

    1.

    36-year-old, G1 P0; induction of labor; gestational diabetes; 39 weeks’ gestation; urine positive for GBS; 36-week ultrasound indicates EFW 3150 g (7 lb); fundal height at 39 weeks is 40 cm; allergy to penicillin

    Rationale: Age is >35, parity, 39 weeks with gestational diabetes and possible macrosomia, need to treat GBS with PCN alternative during induction.

    2.
    Prenatal Data Risk Factor Not a Risk Factor
    Gestational diabetes
    Estimated fetal weight (EFW) of 3,150 g at 36 weeks’ gestation
    A negative
    36 years old
    GBS status
    BP range 118–128/64–80

    Rationale: Age, gestational diabetes, and the EFW increase the risk for prolonged labor and cesarean birth. Gestational diabetes and EFW increase the risk for labor shoulder dystocia.

    GBS status increases the risk for infection.

    Blood type and BP range are normal and not linked to complications of labor.


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