General IM Q10

A 32-year-old woman is evaluated during a domestic airline flight for an episode of weakness and lightheadedness. She is pregnant at 35 weeks' gestation. She has had several contractions since take-off but without regularity. She reports no abdominal pain. She has no medical problems, and her only medication is a prenatal vitamin.

On physical examination, the patient appears weak. Temperature is normal, blood pressure is 105/60 mm Hg, pulse rate is 99/min, and respiration rate is 14/min. Her skin is clammy. Cardiovascular examination is unremarkable. Lungs are clear to auscultation. On abdominal examination, she has a gravid uterus.

Oxygen, 2 L/min by nasal cannula, is started. An intravenous line is placed, and fluids are initiated

Which of the following is the most appropriate next step in management?

A Ask the pilot to descend to a lower altitude

B Connect with the ground-based physician

C Recommend flight diversion

D No further management

Choose an Answer Above

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