FCOG-1091

A 21-year old female, gravida 1 para 0, term pregnancy, comes in due to labour for eight hours. Two hours prior to onset of contractions, her membranes have allegedly ruptured. Fetal heart rate is at 144/min. Contractions are of good quality, noted every 2-3 minutes, with a duration of 45 seconds. On examination, her cervix is fully dilated and the patient has been pushing all throughout. Vertex is palpated in the occipito-anterior (OA) position and has descended to station 2 cm below the ischial spines in the previous hour. Which of the following most likely depicts the current condition of the patient?