28.4: Chapter 18
Unfolding Case Study
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.
| 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.