Welcome to episode 521 of the Divine Intervention Podcast.

In today's podcast, I'm going to be continuing the series on the free 120 for step two,

the one that's presently right now in 2024 on the USMLE's website.

We've done the first 20 questions, so this is going to be part 4.

We're going to start off from question 21. All right, let's get right into it.

A 36 year old woman, gravitated to Para 1 at 39 weeks chess station is admitted to the hospital and labor.

She reports painful contractions that occur every two to three minutes and last 60 seconds. She has not had vaginal bleeding. She has

no history of serious illness and pregnancy has been uncomplicated.

Temperature is 37 degrees Celsius, that's 98.6 degrees Fahrenheit.

Pulse is 84 per minute and regular, and blood pressure is 100 over 70 millimeters of mercury. The abdomen is non tender and consistent in size with a 39

week gestation. External fetal monitoring shows a heart rate of 150 per minute with moderate variability,

several spontaneous accelerations and no decelerations.

An external t talkometer shows regular uterine

contractions every two to three minutes. The cervix is six centimeters

deleted and a hundred percent he faced. The vertex is at zero station.

Ultrasonography shows the fetus in a syphallic presentation.

The membranes are artificially ruptured, yielding copious clear fluid.

30 minutes later, the cervix is 9 centimeters deleted and 100% he faced. The vertex is at plus 1 station. A fetal heart

rate tracing is shown. Which of the following is the most appropriate next step in management?

Option A says, advising the patient to begin pushing.

Option B says Amnio Infusion. Option B says am new infusion.

Option C says expectant management.

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