Good Effort in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#11983
SMLE Question #11983
Obstetrics & Gynecology
General Gynecology
Objective: OBJ-ETH-STERIL
Last updated: February 2026
A 35-year-old G5P4004 at 39 weeks is in active labor. She has been fully dilated for 2 hours and has been pushing with good effort for 1 hour but is now maternally exhausted. She has no epidural. Continuous cardiotocography is category I. Estimated fetal weight is 2.7 kg in cephalic presentation. Vaginal examination shows ruptured membranes, full dilation, and the presenting part at −3 station with the head not engaged; 4/5 of the head is palpable abdominally. There is no clinical evidence of obstructed labor. What is the most appropriate next step in management?
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