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It is the end of the day shift at a rural community hospital. You are called to a 33 week gestation delivery. Maria is 42 years old and is about to deliver her fourth child. She was just diagnosed last week with gestational diabetes. Maria was in a minor car accident today during the morning rush hour. She felt some abdominal cramping after the accident and was transported to the hospital via ambulance. She has had no bleeding, leaking of amniotic fluid, or obvious trauma, but her cramping was diagnosed as preterm contractions. Attempts were made to stop labor using indomethacin, but without success. A fetal ultrasound was done to assess any physical injury from the accident, but none was evident. Fetal age was estimated at 35 weeks gestation during prenatal visits and by ultrasound bipariatal diameter. During the ultrasound, an amniocentesis was also obtained, and a lung profile was sent for analysis. L/S ratio is 1.5;1, and PG is absent.
- What does the lung profile tell you about the baby lung maturity?
-Currently, in what stage of pulmonary development is the fetus?
-Are you concerned about the motor vehicle accident? if so, specifically what concernes you?
- Why do you think Maria fetus is measuring larger than her predicted gestational age?
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