Low vacuum extraction

1. LOW CAVITY VACUUM EXTRACTION(LCVE
)
@aidoo

2. Definition
• Operative delivery is An alternative
method of delivery that is used when
the mother is unable to give birth nor
mally and needs surgical intervention
.

3. Types of Operative Delivery
a) Caesarean delivery
i. Transverse Lower Segment Caesare
an Section (LSCS)
ii. Classical caesarean section
iii. Caesarean hysterectomy

4. Types of Operative Delivery cont...
b ) Operative vaginal delivery
i. Vacuum
ii. Destructive delivery of a dead foetus.
– Includes the following:
– Craniotomy (dead fetus, 2/5 or less of their head must b
e above the brim. If it is higher than this, Caesarean sec
tion is usually safer.
– Head must be impacted.
– Maternal cervix must be at least 7 cm dilated, and prefer
ably fully dilated.
– Uterus must be unruptured, and not in imminent danger
of rupturing) Baby is dead and is lying transversely, cervi
x is 8 cm or more dilated, and maternal uterus is not rup
tured.

5. Low Cavity Vacuum Extraction (LCVE)
Indications for vacuum delivery
 Delayed second stage
 Foetal distress in second stage
 Maternal conditions: requiring short sec
ond stage ,such as:
i. Severe anaemia
ii. Heart failure
iii.Maternal distress

6. Prerequisites for vacuum delivery
 Full dilatation of cervix
 Good uterine contractions
 Adequate pelvis
 Normal size of the baby
 Cephalic presentation
 Descent 3/5 or more
 No caput
 No severe moulding
 Avoiding a vaginal operative delivery for a foetus who
se mother is HIV positive is advisable if possible to m
inimize trauma to the foetal scalp which may increase
maternal foetal HIV exposure

7. Prerequisites for Forceps Application
 The head must be engaged.
 The fetus must present as a vertex.
 The position of the fetal head must be pr
ecisely known.
 The cervix must be completely dilated.
 The membranes must be ruptured.
 There should be no suspected cephalic–
pelvic disproportion

8. Basic rules
 Delivery should be completed within
15 minutes
 Head should descend with each pull
 The cup should be applied no more t
han three times

9. Contraindications of LCVE
 Breech presentation
 Face presentation
 Prematurity
 Any contraindications for Spontaneo
us Vaginal Delivery (SVD), e.g; two p
revious scars, APH, previous perinea
l repair

10. Complications of Low Cavity Vacuum Ext
raction (LCVE)
Maternal:
 Trauma to the genital tract
Foetal:
 Oedema and necrosis of the scalp
 Cephalhaematoma (subperiosteal bl
eed)
 Intracranial haemorrhage (more com
mon in premature babies)

11. THANK YOU