A 28-year-old woman, gravida 3 para 2, with two previous cesarean deliveries presents for prenatal care. Her second pregnancy was complicated by a uterine rupture at 36 weeks of gestation. She asks, “When should I be delivered during the current pregnancy?”
Pregnancies after uterine rupture should be delivered by repeat cesarean at 36–37 weeks of gestation without verification of fetal lung maturity by amniocentesis.
Warren Alpert Medical School of Brown University, Women & Infants Hospital, Providence, Rhode Island; and Denver Health and Hospital Authority, Denver, and the University of Colorado School of Medicine, Aurora, Colorado.
Corresponding author: Torri D. Metz, MD, MS, 777 Bannock Street, MC 0660, Denver, CO 80204; email: Torri.Metz@dhha.org
Financial Disclosure The authors did not report any potential conflicts of interest.
The Clinical Conundrums feature is an article type developed for clinicians who sometimes are faced with either clinical situations or patient questions for which little (if any) information is available to guide decision-making. Clinicians have all been faced with a situation in which they approach a trusted colleague and ask, “Can I run something by you?” The Clinical Conundrums feature attempts to provide answers to those types of questions.
Each author has indicated that she has met the journal's requirements for authorship.