Assessment questionsComments
What is the gestational age?Verify dates by clinical history and ultrasonography
Are the membranes ruptured?History of leaking fluid; observed leakage of fluid from cervical os on sterile speculum examination; nitrazine-positive reaction of fluid; ferning of fluid; ultrasonography for oligohydramnios; amnioinfusion of indigo carmine, if available
Is the patient in labor?Observe for contractions accompanied by cervical effacement and dilation
Is there an infection?Group B streptococcus carrier status; urinary tract infection; bacterial vaginosis; trichomoniasis; gonorrhea or chlamydia
What is the likelihood that the patient will deliver prematurely?Consider endovaginal ultrasonography of cervical length and/or fetal fibronectin testing