Forceps delivery is indicated for maternal exhaustion, prolonged second stage of labor, or medical conditions that require a shortened second stage. It can cause maternal trauma or rare fetal injuries if incorrectly applied. Vacuum extraction uses suction to create artificial caput and is safer for the mother but can cause fetal injuries like scalp lacerations. Both forceps and vacuum extraction have risks and benefits that depend on the situation and should only be used when medically necessary.

2. Indications :
maternal:
 .exhaustion.
.prolonged 2nd stage.
.medical causes:
.sever cardiac disease.
.hypertensive crisis.
.uncorrected cerebral vascular malformation.
.when pushing not possible(paraplegia or tetraplegia).
Fetal:
.fetal distres.
.aftercoming head of breech.

3. Complications:
.maternal trauma.
.rotational forceps may cause spiral tears of
vagina.
.rarely fetal injuries due to incorrect application
of the blades as:
.facial nerve palsy.
.skull fracture.
.orbital injury.
.intracranial hge.

5. Vacuum extraction works on the principle of
creating negative pressure to allow scalp
tissues to be sucked into the cup.this creates
artificial caput called chagnon.
It should not be used at < 34wks gestation.

6. Types:
metal cup– pressure created by suction
pump.
soft cup– cover greater surface area.
kiwi Omni cup–
.single use, quick in emergency as
pressure created with hand pump.

7. Indication:
.delay in second stage.
.fetal distress in 2nd stage.
.maternal conditions requiring short 2nd stage.
Contra-indications:
.face presentation.
.GA< 34wks.
.marked active bleeding from fetal bl. Sampling
site.

10. Indications
.face presentation.
.after coming head of breech
.delivery before 34wk.
Contra-indications:
.head not fully engaged.
.cervix not fully dilated.

11. Complications: asso. with fetal injuries
including:
.scalp lacerations & avulsions.
.cephalohaematoma.
.retinal hge.
.rarely intracanial hge.

12. -Ventouse is more likely to fail.
-ventouse is more likely to cause fetal trauma.
-with ventouse less CS delivery.
-forceps are more likely to cause significant
maternal genital tract trauma.
-ventouse safer for mother but forceps may be
safer for baby.