Vaccum delivery

2. INTRODUCTION
 “Instrumental device designed to assist delivery by applying traction to a suction cup
attached to the fetal scalp”
 Any condition threatened to mother or fetus that is likely to be relieved by delivery.
 Fetus of at least 34 weeks.

3. MATERNAL INDICATION
1. Maternal distress, exhaustion after a long, painful labour, due to inefficient uterine
contractions.
2. Prolonged second stage of labour
3. Maternal medical disorders
4. Previous caesarean section or genital prolapse repair.
5. Intrapartum infection, certain neurological conditions.

4. FETAL INDICATION
 Prolapse of umbilical cord
 Premature separation of placenta
 Fetal distress
 Non rotated heads or occipitotransverse position

5. CONTRAINDICATION
 Inability to assess fetal position
 Suspicion of cephalopelvic disproportion
 Preterm babies (<34 weeks) due to risk of fetal intraventricular haemorrhage
 Macrosomia (>4 kg)
 Soft tissues obstruction in the pelvis
 Breach presentation and face presentation

6. INSTRUMENTATION
 A suction cup with four sizes (30mm, 40mm, 50mm, 60mm)
- Metal cup
- Soft cup
- Silastic cup
- Rigid plastic cup
 vacuum pump

7. PREREQUISITES OF VACUUM EXTRACTION
 Delivery Consent + well informed patient
 Vertex-presentations
 Head -well engaged
 No CPD
 Cervix fully dilated or almost
 Bladder should be empty

9. TECHNIQUES
 Ask for help and Address the patient
 Bladder empty
 Cervix fully dilated
 Determine fetal position and think shoulder dystocia
 Extractor and resuscitation equipment ready
 Flexion point - apply cup
 Gentle traction in the proper axis
 Halt traction when the contraction is over, halt the procedure if it is not progressing normally

11. FETAL COMPLICATION
 Scalp bruising
 Foetal death
 Neonatal jaundice
 Intracranial haemorrhage
 Hypoxia
 hematoma

12. MATERNAL COMPLICATION
 Genital prolapse
 Infection
 Traumatic postpartum haemorrhages
 Soft tissues injuries like cervical tear, extension of episiotomy etc.

13. MANAGEMENT
 To assess the effect on the mother and the fetus
 To start a Ringer's solution drip and to arrange for blood transfusion, if required
 To assess if procedure is to be abandoned and consider delivery by cesarean section
 Laparotomy should be done in a case with rupture of uterus.
 To administer parenteral antibiotic

14. SUMMARY
Today we have discussed about vacuum delivery, its indications along with the
contraindications. We further studied about instruments used, its technique, its
management and complications associated with it.

15. CONCLUSION
Vacuum delivery has been proven to be useful in assisting with vaginal delivery. The
potential for both foetal and maternal injury does exist. The operator must be familiar with
the indications, contraindications, application and use of vacuum device. Safe and
effective guidelines should exist to facilitate a safe and effective delivery.

16. REFRENCES
 https://www.slideshare.net/sunilkumardaha/vacuum-delivery
 https://www.slideshare.net/Abushuraih/vacuum-delivery-250355370