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PubMed1993

A randomized comparison of vacuum extraction delivery with a rigid and a pliable cup.

OBJECTIVE: To compare the effectiveness and complications of obstetric vacuum extraction with a rigid and a pliable cup, with a focus on neonatal retinal hemorrhage. METHODS: One hundred women requiring assisted delivery who met predefined criteria for vacuum extraction were randomly assigned to be delivered by the classic rigid Malmström cup or the pliable Silastic cup. RESULTS: Because of the faster induction of vacuum, delivery occurred more rapidly with the pliable cup, but the pliable cup detached significantly more often than the rigid cup. The overall failure rate was not significantly different between the cups. There were no significant differences between the groups with regard to Apgar scores, umbilical artery pH, birth canal trauma, or maternal blood loss, but scalp injury occurred less frequently with the soft than with the rigid cup. Retinal hemorrhage in the newborns showed a similar incidence of about 50%, and neonatal neurologic examination showed no significant differences between the groups. CONCLUSION: In comparison with the rigid cup, the advantage of the pliable cup is limited to a smaller incidence of neonatal scalp injury.

Adult↗
PubMedDate not supplied

[Vacuum extraction in modern obstetrics].

From 1970 to 1979 the authors analysed 1721 vacuum extractions. The method was introduced into the Department in 1965 and performed in 0.96% of cases. From 1970 to 1980 the use of VE increased from 1.97% to 4.93%. The most frequent indication for its use was the prolonged expulsion phase (49.78%). While in premature children the method was applied rarely (2.32%), in children weighing over 4000 g it was indicated in 16.44% of cases. The newborns delivered by VE proved to have increased traumatic morbidity rates (anoxia perinatalis 25.56%, haemorrhagia intracranialis 20.39%, cephalhaematoma 33.58%). The mortality of newborns delivered by VE amounted to 6.39%. There was 1.10% of unsuccessful vacuum extractions (19 parturients: in 16 forceps and in 3 cesarean section were applied). In the authors' opinion, vacuum extraction is the method of choice in the vaginal operative completion of labour: VE does not diminish the pelvic cavity or fix the position of the head of the fetus but allows the flexion of the head by natural forces. After each unsuccessful vacuum extraction it is necessary to examine its causes. The choice of the method for completing labour depends on the obstetric situation. Intracranial hemorrhages amounting to 20.39% warn the authors to reexamine the methods of their work.

Birth Injuries↗
PubMed1995

[The place of vacuum extraction in modern obstetrics].

A clinical trial was carried out on the use of vacuum extraction for delivery of 45 women. The aim of the study is to revive again this method for it was rarely used during the last years. The authors remind of the indications and necessary condition for the use of vacuum extraction and report about complications and the course of the placental period. Parallel to this, the 45 babies born with vacuum, are followed up according birth weight, gestational age, clinical status and laboratory data by birth, resuscitation after delivery and birth trauma. By summing up the results the authors divide women (and babies) in 3 groups: deliveries with vacuum extraction (VE), VE+ forceps, Vstimmulation and forceps, Conclusions are made that VE is a useful method nowadays if classical conditions and indications are followed. The babies born by VE are in good status without serious traumas. Vstimmulation + forceps is rejected as more harmful method.

Adult↗