The multiparous patient at term has arrived to the labor and delivery unit in active labor with intact membranes. Leopold's maneuver indicates the fetus is in a transverse lie with a shoulder presentation. What physician order is most important?

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The most important physician order in this scenario is to alert the surgical team of urgent cesarean. A transverse lie with shoulder presentation is a medical emergency and vaginal delivery is not possible. Artificially rupturing membranes or applying an internal fetal scalp electrode could increase the risk of compressed cord or shoulder dystocia. Monitoring maternal blood pressure every 15 minutes is important, but not the most urgent concern in this situation.

The Multiparous Patient at Term Has Arrived to the Labor