In pregnancy, the ribs start to flare (expand slightly) as the pressure from the growing fetus moves the diaphragm upwards. Many women experience this during the third trimester as the baby is at it's largest. The flaring of the ribs is assisted by maternal hormones that enable more flexibility throughout the body.

Induction of labor may occur for various indications: diabetes, postmaturity, hypertensive disorders or pregnancy, fetal jeopardy, or logistical factors including distance from qualified hospital or a rate of rapid birth. Induction of labor may only occur if the mother does not have cephalopelvic disproportion (CPD), the fetus has a vertex presentation with an engaged head, and the mother has a "ripened" cervic or is prepared to be "ripened". Fetal macrosomia is a concerning condition and may require intervention, but is typically not resolved by inducing labor. With fetal macrosomia, a cesarean section may be considered instead of vaginal delivery, due to the potential risks of delivering a large infant vaginally.

The most common tumor of the female reproductive tract by far is uterine leiomyoma, also known as a uterine fibroid. Uterine fibroids are benign smooth muscle tumors that grow into the myometrium. They can often cause pain in the lower back or pain during penetration, dysmenorrhea, and menorrhagia.  

While any of the conditions listed can cause abdominal or pelvic pain, the most likely cause of severe pain of sudden onset is ovarian torsion. This is an emergency condition which can result in loss of the affected ovary if not treated within four hours. 

Diethylstilbestrol (DES), a medication used from 1940 to 1971 to reduce the risk of miscarriage, resulted in the later development of clear-cell adenocarcinoma in many of the unborn children of these pregnancies. 

Increasing fluid and oxygen administration may increase the overall oxygenation of the fetus and result in greater variability in heart rate. It is advisable to change the position of the patient, however, a supine position is not compatible with pregnancy. Contacting the provider is an acceptable intervention given concern for fetal well-being.

The most common cause of mucopurulent cervicitis is chlamydia trachomatis, followed by neisseria gonorrhea. Human papillomavirus, while it is associated with increased risk of development of cervical cancer, does not cause mucopurulent cervicitis, nor does herpes simplex.

Placental aromatase deficiency is a condition that prevents testosterone from being aromatized into estrogen during pregnancy. This results in a temporary masculinization of the mother that does not continue past delivery. Neither chloasma nor growth hormone deficiency result in masculinization, and masculinizing symptoms of polycystic ovarian syndrome often improve during pregnancy, rather than getting worse. 

Lichen sclerosus is a condition that presents as vulvar pruritus and pain with porcelain-white vaginovulvular atrophy. It is most common in post-menopausal women, though it does occur on occasion in younger women and girls. While all of the other conditions listed can cause puritis and pain, none of them are associated with frank atrophy.   

The Amsel criteria for bacterial vaginosis are as follows: clue cells seen on microscopic examination, a positive "whiff" test on addition of potassium hydroxide to the vaginal discharge, a vaginal pH > 4.5, and thin gray or white vaginal discharge.