This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Episiotomy, Subject name: Gynaecology & Obstetrics
[{'content': 'In which of these patients can a medial episiotomy be considered superior to a medio lateral episiotomy during delivery of fetus? \nSelect and explain. \nA. Nulligravida with thick perineum, B. Second stage arrest, C. Second gravida with moderate anemia, D. Before application of forceps', 'role': 'user'}, {'content': 'Answer: C \nExplanation: A midline episiotomy is associated with higher risk of third and fouh degree lacerations and following factors are associated with an increased risk.: Nulliparity Second-stage arrest of labor Persistent occiput-posterior position, Midorlowforceps Use of local anesthetics Asian race. A medio lateral episiotomy should beperformed in these mentioned situations A multiparous patient with anemia does not have increased risk for third or fouh degree laceration and since the patient is anemic, with a midline episiotomy, blood loss is less and healing is better, making it a better option.', 'role': 'assistant'}]