hanwin
Forum Senior
Topics: 6
Posts: 157
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19 yr old, primipara, back pain and uterine contraction.
OE membrane intact, os 1 cm and effacement 50%.
14 hrs later, os 2 cm and 80% effacement. There is paraspinal tenderness.
What is the diagnosis?
1. PID
2. Prolonged latent stage
3.----
4.----
5.----
3,4 5 is unlikely ans to me. I can't remember.
Which one is the correct ans?
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| elitoki
Forum Guru
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2. prolonged latent stage.
Paraspinal tenderness is muscular pain, so it could be caused by pronlonged latent stage.
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| hanwin
Forum Senior
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Posts: 157
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That's what I thought.
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| MAGY17
Forum Elite
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l`m no agre, because in primipara latent phase is up to 20 hs and this case has only 14 hrs, can you please write the other choice?
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| hanwin
Forum Senior
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Posts: 157
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I can't remember.I thought other cause are very unlikely.
What do you thnink?
Real Q s are not similar to UW ,Kaplan , NBME.
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| claudia_i
Forum Senior
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My 2 cents: I would not say there is prolonged latent phase until it's > 20hr in a primipara. If there were no other indications for a cause for back pain before the labor started, my guess is that we might have an occiput posterior position, which is the most common abnormal presentation. The back of the baby's head is pressing on the maternal sacrum, streching the sacroiliac joints and causing low back pain.
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| hanwin
Forum Senior
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No choice like OP position in this Q.
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| claudia_i
Forum Senior
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Coccygodynia?
Sacroiliac joint malfunction?
There is a hormone called relaxin which helps with loosening of the sacroiliac joint and softening of the cervix. However, I think that asking about such thing is way beyond the scope of step 2 CK  ...
Edited by claudia_i on 08/23/07 - 10:47 PM
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| liliaeliz
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