In the same presentation as above (38 weeks, SROM, contractions), what is the appropriate course of action?

• A. Discharge home with instructions
• B. Admit to the Labor and Delivery Unit
• C. Schedule a home birth
• D. Initiate tocolysis and discharge

Answer: (B)

Active labor at term with rupture of membranes and contractions requires admission to Labor and Delivery for ongoing assessment and management. When membranes have ruptured, the risk of infection increases, and monitoring fetal status, contractions, and labor progression is essential to ensure a safe delivery plan. Admitting allows continuous evaluation, IV access, fluids, maternal vital signs, and fetal heart rate monitoring, and enables timely decisions about analgesia, labor augmentation if needed, or cesarean if complications arise. Tocolysis to halt labor is not appropriate once membranes are ruptured and labor is underway, and discharging home or scheduling a home birth during active labor would miss the need for close surveillance and could delay urgent interventions.