A client with PCOS is prescribed metformin. What is the purpose of using this medication with PCOS?

True labor is defined by progressive cervical effacement and dilation resulting from regular, rhythmic uterine contractions. Unlike pre-labor warming, these contractions intensify with ambulation and do not subside with rest or hydration. The physiologic retraction ring forms as the upper uterine segment thickens.

A. False labor: Also known as Braxton Hicks contractions, these are typically irregular and do not increase in intensity or frequency over time. They often resolve with rest, a change in position, or increased fluid intake. Most importantly, false labor does not result in any measurable changes to the cervix.

B. Latent phase only: While the latent phase is the beginning of true labor, the question describes the overall progression of contractions seen across the entire labor process. The latent phase specifically refers to the period where the cervix dilates from 0 to 6 centimeters. It is a subset of the labor process.

C. True labor: The hallmark of true labor is the systematic increase in contraction frequency and strength that leads to cervical change. These contractions usually begin in the lower back and radiate to the abdomen. They create the mechanical force necessary to push the fetus against the internal os for dilation.

D. Preterm labor: This refers to the timing of labor occurring before 37 weeks of gestation rather than the nature of the contractions themselves. While the description of the contractions is accurate for labor, "true labor" is the general term for the physiological process described. Preterm labor is a gestational age classification.

Chorionic Villus Sampling (CVS) is a diagnostic procedure performed between 10 and 13 weeks to detect chromosomal abnormalities. It involves aspirating a small sample of placental tissue either transcervically or transabdominally. While providing early results, it carries a slightly higher risk profile than mid-trimester amniocentesis.

A. Bleeding: The insertion of a catheter or needle into the developing placenta can cause subchorionic or vaginal bleeding. Most post-procedure bleeding is minor, but it must be monitored to ensure it does not lead to pregnancy loss. This risk is inherent to invasive sampling techniques.

B. Infection: Any procedure that bypasses the natural protective barriers of the cervix or skin can introduce bacteria into the uterine cavity. Chorioamnionitis is a rare but serious complication that can jeopardize both the pregnancy and maternal health. Strict aseptic technique is required during the procedure.

C. Fetal anemia: This is not a typical risk associated with CVS, as the sample is taken from the placenta rather than the fetal circulation. Fetal anemia is a more common risk of percutaneous umbilical blood sampling (PUBS). CVS focuses on genetic material within the trophoblastic cells.

D. Hypertension: The CVS procedure does not cause systemic maternal hypertension or preeclampsia. While a client may experience transient stress-induced tachycardia, there is no physiological link between placental tissue sampling and the development of gestational hypertension. It does not alter blood pressure.

E. Miscarriage: CVS carries an estimated procedure-related pregnancy loss risk of approximately 0.2% to 1.0%. The mechanical disruption of the gestational environment or subsequent infection can trigger spontaneous abortion. Counseling must include this risk to ensure informed consent by the client.