PubMed · 3080165
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1986-02-01. Vacuum extraction or forceps?. https://doi.org/10.1136/bmj.292.6516.343-c
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With any operative vaginal delivery, it is important to document in the medical record the indications for the procedure, including the position and station of the vertex and specifics of technique, timing, and ease of the procedure. The use of cord pH and blood gas determinations may be helpful for further evaluation of the fetus.
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A retrospective study over a 5-year period reviewed 71 unexpected failures of instrumental delivery and compared them with a group of 21 trials of ventouse to identify causes for failure and their impact on neonatal outcome. There was a statistically significant difference between the two groups in terms of pre-application assessment of fetal size, maternal pelvis and palpable fetal head above the pelvic brim (P less than 0.00001). There was also a significant difference in neonatal morbidity (P less than 0.01). All 5 neonatal deaths occurred in the failure group and were associated with multiple instrumentation.