A fetal head is palpated at the left occiput posterior position at station +2 on vaginal examination with no further progress for 2 hours in the second stage. The most appropriate instrumental delivery technique is:

• A Kielland's rotational forceps to rotate to OA then deliver
• B Ventouse (vacuum) with flexion cup applied to flexion point for rotation and delivery
• C Manual rotation followed by Neville-Barnes forceps ✓
• D All of the above are equally acceptable

Explanation

For occipito-posterior position at +2 station, manual rotation to occipito-anterior followed by direct Neville-Barnes (outlet) forceps is a widely used technique that is safer than Kielland's rotational forceps (higher maternal trauma risk) in less experienced hands. Ventouse can be used but has a higher failure rate with OP positions. Kielland's forceps remain an option but require specific expertise. Manual rotation is often performed before application of non-rotational forceps.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.