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Preterm premature rupture of membranes — USMLE Step 2 CK MCQ

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ModerateObstetrics & GynecologyPreterm premature rupture of membranesUSMLE Step 2 CK

A 38-year-old White woman comes to the urgent care clinic because of pelvic symptoms or pregnancy-related concerns. History and focused examination are notable for fluid leakage, pooling, ferning, and 32-week gestation without labor. 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: E — Preterm premature rupture of membranes

The vignette describes Preterm premature rupture of membranes, supported by fluid leakage, pooling, ferning, and 32-week gestation without labor. Preterm premature rupture of membranes 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: ACOG Practice Bulletin on Prelabor Rupture of Membranes