This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Medical, surgical and gynaecological illness complicating pregnancy, Subject name: Gynaecology & Obstetrics
The best method of cuailing the second stage of labour in hea disease is by 
Select and explain. 
A. Prophylactic forceps, B. Prophylactic ventouse, C. Spontaneous delivery with episiotomy, D. Caesarean section
B: Prophylactic ventouse
Answer: B: Prophylactic ventouse 
Explanation: Seccond stage management in a Hea disease complicating Pregnancy Maternal pushing and the tendency to delay in the second stage of labour is to be cuailed by forceps or ventouse under pudendal /perineal block Ventouse is preferable to forceps as it can be applied without putting patient in lithotomy position IV ergometrine after the delivery should be withheld to prevent sudden overloading of the hea by additional blood squeezed out from the uterus Reference: D.C.Dutta&;s Textbook of Obstetrics; 7h edition; Page no: 278