During the second stage of labour, a multiparous woman develops prolonged fetal bradycardia to 90 bpm for 5 minutes. Station is +2, vertex presentation, occiput anterior, cervix fully dilated. The quickest method to achieve expeditious delivery is:

• A Outlet forceps delivery ✓
• B Emergency cesarean section (Category 1 LSCS)
• C Vacuum extraction with Kiwi Omnicup
• D Fundal pressure (Kristeller manoeuvre) to accelerate descent

Explanation

With the head at station +2 (occiput anterior, vertex presentation, fully dilated cervix), outlet forceps delivery is the fastest method for expeditious delivery of a baby in acute fetal distress during the second stage. Forceps are applied directly and can effect delivery within minutes, faster than emergency cesarean (which requires theatre preparation). Vacuum extraction requires cup application and active maternal pushing, which may be slower in an acute emergency. The Kristeller manoeuvre is not recommended (risks uterine rupture and is not evidence-based). Outlet forceps is the preferred option when conditions are met.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.