Ventouse is an instrumental device designed to assist delivery by creating a vacuum between it and the fetal scalp . The pulling force is dragging the cranium while in forceps ,the pulling force is directly transmitted to the base of the skull Vacuum extractor consists of A specially designed cup with a diameter of 30mm, 40mm, 50mm and 60 mm A rubber attaching the cup to a glass bottle with a screw in between to release the negative pressure A manometer fitted in the mouth of the glass Another rubber tube connecting the bottle to a suction piece which may be manual or electronic creating a negative pressure

1. VENTOUSE / VACUUM DELIVERY
BY
URIKKHINBAM SONIA
LECTURER
MSC NURSING OBG

2. DEFINITION
Ventouse is an instrumental device designed to assist delivery by
creating a vacuum between it and the fetal scalp .
The pulling force is dragging the cranium while in forceps ,the pulling
force is directly transmitted to the base of the skull

3. INSTRUMENT /EQUIPMENT
DESCRIPTION
Vacuum extractor consists of
 A specially designed cup with a diameter of 30mm, 40mm, 50mm and
60 mm
 A rubber attaching the cup to a glass bottle with a screw in between
to release the negative pressure
 A manometer fitted in the mouth of the glass
 Another rubber tube connecting the bottle to a suction piece which
may be manual or electronic creating a negative pressure

4. TYPES
On the basis of the type of cup , vacuum extractors are divided into
1. Metal cup vacuum extractors
2. Soft cup vacuum extractors
METAL CUP were initially used . Mushroom shaped . High success rate .Due to
rigidity of metal cups application difficult and uncomfortable increased risk of fetal
scalp injuries .
example : malmstrom cup ,birds cup
SOFT CUP - silicone rubber or disposable plastic cups .bell or funnel shaped .
used with a manual vacuum pump or electrical suction device .
Have better adherence to the fetal scalp , can be folded and introduced into the
vagina without discomfort .
Example : kiwi cup

5. a- silic cup, b –kiwi omni cup –soft
cup
c- metal cup

6. INDICATIONS
 MATERNAL
o Maternal distress
o Prolonged 2nd
stage of labor
o Medical disorders such as heart disease ,HTN, anaemia
 FETAL
o fetal distress or prematurity
o After coming head of breech

7. CONTRAINDICATIONS
 Any presentation other than vertex
 Preterm less than 34 weeks
 Suspected fetal coagulation disorders
 Suspected fetal macrosomia more than or equal 4kg

8. PROCEDURE
PRELIMINERIES
1) Anesthesia –either general or local .
2) Position –lithotomy
3) Full surgical asepsis
4) To empty the bladder
5) Vaginal examination is done
Pudendal block or perineal infiltration with 1% lignocaine is
sufficient .It may be even without anesthesia in various women .The
instrument should be assembled and the vacuum is tested prior to its
application .

9. steps
1. Application of the cup :
 The largest possible cup is to be selected .The cup is introduced after
retraction of the perineum with two fingers of the other hand.
 The cup is applied against the fetal head nearer the occiput with the knob
of the cup pointing towards the occiput .
 Antiseptic solution is applied to the rim of the metal cup.
 A vacuum of 0.2 kg/cm2 is induced by the pump slowly, taking atleast 2mins
 A check is is made using the fingers round the cup to ensure that no
cervical or vaginal tissue is trapped inside the cup .
 The pressure is gradually raised at the rate of 0.1kg /cm2 per minute until
the effective vacuum of 0.8 kg/cm2 is achieved in about 10 mins

11. 2.Traction
 Traction must be at right angle to the cup
 Traction should be synchronous with the uterine contraction .it is
release between uterine contraction
Operative vaginal delivery (forceps /ventouse ) should be
abandoned ,where there is no descent of the presenting part with
each pull or when delivery is not imminent after the three pulls with
correctly applied instruments by an experienced operater .

13. COMPLICATIONS
 Maternal – uncommon
 Neonate
superficial scalp
cephalohematoma
Intracranial hemorrhage
retinal hemorrhage
Jaundice
Sloughing of the scalf

14. Thank you