This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Gynaecology & Obstetrics
[{'content': 'Forceps delivery is done in all except: \nSelect and explain. \nA. Mentoposterior, B. Deep transverse arrest, C. After coming head, D. Maternal heart disease', 'role': 'user'}, {'content': 'Answer: A \nExplanation: Option ‘a’\nMentoposterior: Before going on to mentoposterior, lets see mentoanterior.\nMentoanterior\n\u200bDutta Obs. 7/e, p 390\nIn mentoanterior face presentation there is place for spontaneous vaginal delivery and liberal episiotomy is all that is required. In case of delay, forceps delivery is done.\nIn mentoposterior: 20 to 30% cases rotate anteriorly through 3/8 of circle and deliver as mento anterior, there fore trial of labour may be given in hope of anterior rotation of chin, followed by spontaneous/forceps delivery. In the rest 70-80%, incomplete anterior rotation/ non rotation occurs.\nIn these persistent mentoposterior: cesarean section is the only management. Therefore in mentoposterior per se forceps is not applied, only when it rotates anteriorly and becomes mentoanterior, forceps are applied.\nOption ‘b’\nDeep transverse arrest\nManagement options in case of deep transverse arrest are:\nDutta Obs. 7/e, p 372\nVentouse: Ideal for all cases\nCesarean section: If the pelvis is android or there is CPD, cesarean section should be done. In modern obstetrics, traumatic vaginal delivery causing intracranial hemorrhage is to be avoided at all costs and so there is increasing use of cesarean section for deep transverse arrest.\nOther options are:\n\nManual rotation followed by outlet forceps application.\nForceps rotation and delivery using Keilland forceps.\nCraniotomy if the baby is dead.\n\nAs far as options ‘c’ and ‘d’ are concerned: In after coming head of breech, and in heart disease forceps are routinely applied.', 'role': 'assistant'}]