Preterm Labor

Which of the following is the most common identifiable cause of preterm labor in singleton pregnancies?

A 28-year-old primigravida at 32 weeks of gestation presents to the emergency department with complaints of vaginal bleeding and lower abdominal pain for the past 6 hours. On examination, she is hemodynamically stable with blood pressure 118/76 mmHg and heart rate 88/min. Abdominal examination reveals mild tenderness over the lower abdomen. Speculum examination shows blood in the vagina but no cervical lesions. Cervical examination reveals cervical dilation of 2 cm with intact membranes. Ultrasound shows a normally located placenta with no evidence of abruption. Fetal heart rate is 145 bpm. She is not in active labor. What is the most appropriate next step in management?

A 32-year-old primigravida at 28 weeks of gestation presents with vaginal bleeding and uterine contractions (3–4 per 10 minutes). Cervical examination shows 2 cm dilation. Fetal heart rate is reassuring. What is the drug of choice for tocolysis in this patient?

A 32-year-old primigravida at 32 weeks of gestation presents to the labour ward with complaints of vaginal spotting and lower abdominal cramps for the past 6 hours. On examination, her cervix is 2 cm dilated, 80% effaced, and contractions are occurring every 5 minutes. Fetal heart rate is 140 bpm and reactive. She has no fever, and rupture of membranes has been ruled out. What is the most appropriate immediate next step in management?

A 28-year-old multiparous woman at 30 weeks of gestation presents with regular uterine contractions every 3–4 minutes and vaginal bleeding. Cervical examination reveals 3 cm dilation and 70% effacement. Speculum examination shows pooling of fluid consistent with rupture of membranes. Fetal heart rate is 145 bpm and reactive. What is the most appropriate next step in management?