What is the primary concern when a 29-week pregnant patient arrives at the ED?

The primary concern when a 29-week pregnant patient arrives at the emergency department is to ensure the safety and well-being of both the mother and the fetus. At this stage of gestation, the fetus is considered preterm and may face significant risks if born early. Therefore, transferring the mother to a facility with neonatal intensive care unit (NICU) capabilities is crucial because such facilities are equipped to handle potential complications associated with preterm birth.

NICUs have specialized staff and resources to provide the necessary care for premature infants, who may require advanced medical interventions and monitoring. The decision to transfer also ensures immediate access to specialized care should the need arise during the remainder of the pregnancy or in the event of premature labor.

Other considerations, such as stabilizing vital signs, performing an ultrasound, or consulting a pediatrician, are important but secondary to ensuring that the mother is in a facility where comprehensive care for a potentially premature infant is readily available. Thus, the priority is the transfer to a facility capable of managing the complex issues that can arise with premature delivery.