A G4, P3, L3 woman has come in labor at 30-week gestation. On pervaginal examination she is 7cm dilated, fully effaced, membranes intact with face presentation and mentum directed anteriorly. How is she managed?
Ans. C. Watch for progress of labora. Multigravida, in active labor, preterm baby and mentoanterior position, can be observed for progress of labor where with progressing uterine contraction and continued flexion of the head the face might revert to vertex position or anterior rotation of the mentum can occur in which case vaginal delivery can be accomplished.b. Performing amniotomy is an unnecessary intervention in preterm labor, which will augment labor and interfere with the normal progress. It is not done unless indicated.c. Steroids are not given in this case for fetal lung maturation even though the fetus is < 34week, as the woman is much advanced in labor and will deliver before the steroid can take effect. The beneficial effect of steroid begins 24 hours after the first dose and lasts till 7 days.
Take her up for immediate Caesarean section
Give her steroids and watch for progress of labor
Watch for progress of labor
Perform amniotomy
Miscellaneous (Obs)