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
The best method of curtailing the second stage of labour in heart 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: Management of heart disease patient in 2nd stage:
No maternal pushing and the tendency to delay in the second stage of labor is to be curtailed by forceps or ventouse under pudendal and/or perineal block anesthesia. Ventouse is preferable to forceps as it can be applied without putting the patient in lithotomy position (raising the legs increases the cardiac load).