Maternal complications of vacuum extractor delivery, including cervical and vaginal trauma, are generally less frequent and less severe than those of forceps delivery, and this is one of the major advantages of the instrument. Remove the vacuum cup when jaw of the infant can be reached or is delivered.Д¬ontraindications for use of the vacuum extractor include the following: A midline episiotomy has increased risk of third- and fourth-degree perineal lacerations. Make an incision for episiotomy, if necessary. A cesarean delivery is likely a better choice (intracranial hemorrhage is more common after a failed vacuum extraction followed by a forceps delivery). Use caution when attempting a forceps delivery after a failed vacuum extraction (only if the vertex is right on the perineum). Some studies indicate increased incidence of cephalohematoma when vacuum application time until delivery exceeds 5 minutes. Halt the procedure if the cup disengages more than three times, if no progress is noted after three consecutive pulls, or if a delivery does not occur after 20 minutes of intermittent traction. Repeat the gentle traction cycle with the next contraction. decreased cephalohematoma or fetal scalp injury). While vacuum pressure is traditionally reduced to 10 mm Hg between contractions, release of pressure between contractions does not seem to be associated with improved fetal outcomes (e.g. Halt traction when the contraction is over. Neonatal complications are not significantly different, comparing fetal scalp electrode with vacuum-assisted vaginal delivery and vacuum-assisted vaginal delivery alone. If the cup detaches, consider the following problems: inadequate vacuum suction, trapped maternal tissue, a fetal scalp electrode in the way, incorrect application of the extractor (not over the flexion point), or bending or rotation of the shaft. (The angles and traction are more difficult for OP deliveries, with the handle often pointing toward the floor.) Incorrect vectors cause the cup to вЂњpop offвЂќ the fetal vertex. 3.ДЄs the fetal head moves around the symphysis and extends, the vacuum handle will rise from a horizontal to a nearly vertical position. 2.Дo not rock or torque the cup or handle. G.ДЄpply traction at right angles to the plane of the applied surface of the cup.

Д¬alibrate the vacuum dials, noting that yellow (10 mm Hg) is the resting suction and that red (50 mm Hg) is the suction pressure required for traction during contractions.Sweep the finger around the cup to check for trapped maternal tissue. Place the cup over the posterior fontanelle (or over the sagittal suture up to 3 cm in front of the posterior fontanelle, toward the fetal face). Insert and apply the cup over the posterior fontanelle. E.Д®quipment and extractor ready (vacuum and tubing, infant suction bulb, cord clamp, instrument table, etc.)? When the pump is inflated against a sterilely gloved hand, does it hold pressure? F. Дescent should be to a +2 station, with the vertex filling the sacrum.ДЇind the ear, feeling which way it bends.Posterior fontanelle is smaller and forms a Y. ДЄnterior fontanelle is larger and forms a cross.Consider shoulder dystocia (i.e., why is there a delay?). Determine the position of the fetal head.

Vacuum extractor