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Discussion

Help with a Brain Teaser

i am currently taking my a&pii classes for my nursing pre-reqs. we have weekly discussion questions and this one has me completely stumped. i have researched and also asked my own gyn - he did not know either. please help!!!

an obese woman reports to the er with complaints of gas pains. after carefully examination, the er physician calls for a pregnancy test which came back negative. the woman insisted it was a waste of time as she performed the same test earlier that same morning. further observation caused the physician to check for dilation of the cervix which measured 8 cm. briefly describe a physiological explanation for this occurance.

now i am assuming that the pregnancy test at the hospital would have been a blood test. can the blood test be false? is she really pregnant and ready to deliver the baby and not know she was pregnant or is there another medical reason the cervix could dilate without pregnancy?

any help would be appreciated.

frantic nursing student :uhoh3:

danielle

Featured Replies

When I worked L&D I had an obese woman screaming in pain brought in by ambulance. The ambulance personnel just timed her screams and decided she was in labor, as she screamed every 4 minutes and so brought her to us rather than to ER. She delivered a healthy 8lb baby about 15 minutes from arriving on the floor. Later she showed me pictures on her phone of the negative results of several pregnancy tests she had done. All urine.

I never did find out why they were all negative. She also insisted that she had continued to have her period regularly throughout the previous nine months.

No answers....but a similar scenario

Is it possible that she had a missed miscarriage late in the first trimester? Once the baby had died her levels would fall giving her the negative result. Her body was trying to deliver the baby therefore she was dilating.

Is it possible that she had a missed miscarriage late in the first trimester? Once the baby had died her levels would fall giving her the negative result. Her body was trying to deliver the baby therefore she was dilating.

I think its unlikely she would reach advanced dilation at that stage in the pregnancy. I have seen pre-termers deliver at 4-5 cm and that's considerably bigger than a first trimester fetus would be.

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