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Shoulder dystocia — USMLE Step 2 CK MCQ

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HardObstetrics & GynecologyShoulder dystociaUSMLE Step 2 CK

A 31-year-old African American woman comes to the clinic because of pelvic symptoms or pregnancy-related concerns. History and focused examination are notable for delivery of the head followed by failure of the shoulders to deliver. Temperature is 98.6°F (37.0°C), blood pressure is 126/78 mmHg, pulse is 84/min, respirations are 16/min, and oxygen saturation is 98% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and initial testing support the clinical pattern described in the stem. Which of the following is the most likely diagnosis?

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Correct answer: A — Shoulder dystocia

The vignette describes Shoulder dystocia, supported by delivery of the head followed by failure of the shoulders to deliver. Shoulder dystocia is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: https://www.acog.org/clinical/clinical-guidance#stage-9-order-97