At 32 weeks gestation with contractions and vaginal discharge, what is the priority action?

• A. Assess for preterm labor; monitor contractions and fetal status; notify OB
• B. Administer tocolytics and discharge
• C. Schedule elective induction
• D. Reassure and ignore symptoms

Answer: (A)

Contractions at 32 weeks with vaginal discharge point to possible preterm labor, so the priority is to assess for signs of preterm labor and protect both mother and fetus by escalating care promptly. Start with evaluating how often the contractions occur, how long they last, and how strong they feel, while monitoring the fetal heart rate to detect any distress. Check whether membranes have ruptured and look for infection signs, such as fever or uterine tenderness. A quick cervical assessment may be needed to see if there is dilation or effacement, and maternal vitals should be checked to identify any instability. This information guides immediate decisions with the obstetric team—whether to admit for monitoring, administer steroids for fetal lung maturity if appropriate, or consider tocolysis if there are no contraindications. Discharging or simply reassuring without thorough evaluation would miss a time-sensitive risk, so the safest, most appropriate action is to assess thoroughly and involve the OB promptly.