This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: General obstetrics, Subject name: Gynaecology & Obstetrics
Perineal injury can be prevented in vaginal delivery by all except : 
Select and explain. 
A. Maintaining flexion of the head, B. Timely episiotomy as a routine, C. Slow delivery of the head In between contractions, D. Effective perineal guard
B: Timely episiotomy as a routine
Answer: B: Timely episiotomy as a routine 
Explanation: Prevention of perineal laceration Delivery by early extension avoided: flexion of the subocciput comes under the symphysis pubis so that lesser suboccipito-frontal 10 cm diameter emerges out of introitus Spontaneous forcible delivery of head is to be avoided by assuring patient not to bear down during contractions To deliver head in between contractions To perform timely episiotomy To take care at delivery of shoulders D.C.DUTTA'S TEXTBOOK OF GYNECOLOGY, Pg no:137,7th edition