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148881 Gynaecology & Obstetrics

A 30-year-old G2P1001 patient comes to see you in the office at 37 weeks gestational age for her routine OB visit. Her first pregnancy resulted in a vaginal delivery of a 9-lb, 8-oz baby boy after 30 min of pushing. On doing Leopold maneuvers during this office visit, you determine that the fetus is breech. Vaginal exam demonstrates that the cervix is 50% effaced and 1 to 2 cm dilated. The presenting breech is high out of the pelvis. The estimated fetal weight is about 7 lb. You send the patient for a sonogram, which confirms a fetus with a frank breech presentation. There is a normal amount of amniotic fluid present, and the head is well flexed. As the patient’s obstetrician, you offer all the following possible management plans except

AAllow the patient to undergo a vaginal breech delivery whenever she goes into labor
BSend the patient to labor and delivery immediately for an emergent cesarean section
CSchedule a cesarean section at or after 39 weeks gestational age
DSchedule an external cephalic version in the next few days
Gynaecology & Obstetrics
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