PAEA OB-GYN End of Rotation (EOR) Practice Exam 2026 - Free OB-GYN EOR Practice Questions and Study Guide

During a physical examination of a pregnant patient, an increased splitting of the second heart sound with inspiration is a normal finding. This phenomenon occurs due to the increased blood volume and cardiac output associated with pregnancy, which leads to changes in hemodynamics. As the heart works harder and there is increased venous return, the sounds of the heart can become more pronounced and may exhibit a wider split during inspiration. This is typically a benign physiological adaptation rather than a pathological condition.

The other options reflect findings that are not considered normal during pregnancy. A diastolic murmur can sometimes indicate underlying issues, while facial edema is generally seen as a concerning sign, especially when pronounced, as it can suggest possible conditions such as preeclampsia. Hyperreflexia can also indicate neurological concerns and is not a typical finding during pregnancy. Therefore, the increased split of the second heart sound during inspiration is the only option that aligns with normal physiological changes seen in pregnant patients.