Patient History: A 31-year-old G4 P3003 woman at 36 weeks gestation is admitted to the labor and delivery unit for evaluation of uterine contractions . She has a known twin pregnancy, and throughout the pregnancy , she had significant nausea and vomiting, but otherwise, her prenatal course has been unremarkable. Serial ultrasound examinations have been performed showing concordant growth of the twins. She takes prenatal vitamins, an iron supplement, and folic acid. Physical Examination: Blood pressure is 110/70 mm Hg, a pulse is 80 beats per minute (bpm), and respiratory rate is 18 breaths per minute. Fundal height is 41 cm.
Her cervix is 4 cm dilated and 90% effaced. Ultrasound examination reveals a twin pregnancy with a dividing membrane and adequate amniotic fluid. The twins are presenting vertex/vertex. After 2 hours of labor, the patient dilates to 6 cm. Artificial rupture of…
