A 40-year-old (G2-T1-P0-A0-L1) client at 38 weeks gestation was admitted after reporting an increased frequency of contractions and duration while at home. The client was 100% effaced on exam, and 10 cm dilated. She is having contractions every six to seven minutes lasting approximately 45 seconds.

The client was diagnosed with gestational diabetes and had difficulty with maintaining euglycemia because of the inability to adhere to the prescribed insulin schedule. The client has a history of alcohol use disorder and through outpatient treatment, she reports maintaining sobriety during her pregnancy. Periodic ethanol levels during her pregnancy were all zero.