The best method of curtailing the second stage of labour in heart disease is by:
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).
Prophylactic forceps
Prophylactic ventouse
Spontaneous delivery with episiotomy
Caesarean section