30-year-old, 32 week gravid,  G5 P3013 female presents to clinic with vaginal bleeding.  She denies any contractions, leakage of fluid, or trauma.  She states that 4 weeks previously she engaged in vaginal intercourse with her husband and had some mild “spotting” that spontaneously resolved over the course of 24 hours.  BP-110/60, HR-97, RR-20, Temp-98.9o F, and O2 saturation 100% on room air.  Physical examination reveals a soft, non-tender abdomen with fundal height approximately 30cm from pubic symphasis.  Fetal heart tones are present and range from 140-150 bpm.

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