This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Abnormal labor, Subject name: Gynaecology & Obstetrics
In a case of direct occipitoposterior position (face to pubis delivery) most commonly encountered problem is: 
Select and explain. 
A. Intracranial Injury, B. Cephalhematoma, C. Paraurethral tears, D. Complete perineal tears
D: Complete perineal tears
Answer: D: Complete perineal tears 
Explanation: In minority :provide the fetal and maternal conditions permit one should teke a watchful expectancy for the anterior rotation of the occiput and descent of head.In occipito sacral position spontaneous delivery as face to pubis may occur.In such cases proper conduction of delivery and liberal episiotomy should be done to prevent complete perineal tear. D.C.DUTTA&;S TEXTBOOK OF OBSTETRICS,Pg no:371,7th edition