<s>[INST] ### Problem
A 32-year-old primigravida at 39 weeks of gestation presents to labor and delivery with painful contractions and a temperature of 100.5°F (38°C). The fetal heart rate tracing shows a baseline of 180 beats per minute with variable decelerations to 100 beats per minute. The uterine contractions are 2–3 minutes apart and last for 90 seconds. She reports a strong urge to push and has a cervical dilation of 8 cm with 80% effacement. 
a) What is the most likely diagnosis?[/INST]