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PubMed1985

[Significance of trial vacuum extraction in the framework of obstetric surgery in vertex presentation].

On the basis of a clinical study of 76 infants born by trial vacuum extraction from the pelvic inlet, 57 infants were examined retrospectively with regard to early and late morbidity after "successful" trial vacuum extraction. In 34 cases surgery was indicated because of fetal distress; in 23 children the operation was performed because of a standstill at the pelvic inlet. The results were compared with a group of infants delivered by vacuum and forceps extraction from the centre of the pelvis (or the pelvic floor) or cesarean section in consequence of fetal distress. The results indicate the high risk for children born by trial vacuum extraction, especially in cases of fetal distress. In addition to statistically significant lower Apgar scores and a statistically significant higher acidosis morbidity (p less than 0.05) as compared to other obstetric operations, there is also a statistically significant greater number of "striking" and "injured" children as opposed to those delivered by vacuum or forceps extraction from the centre of the pelvis (or the pelvic floor) or by cesarean section in consequence of fetal distress. These neurological deviations represent primarily the static-motoric and speech development, and are analogous to late morbidity after births from breech presentation. The findings confirm the clinical impression that trial vacuum extraction-especially in cases of fetal distress at the pelvic inlet-represent an additional risk to the child. In such cases cesarean section is the only alternative method of delivery.

Apgar Score↗
PubMed1992

Operative vaginal delivery. ACOG Technical Bulletin. Number 152--February 1991.

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.

Extraction, Obstetrical↗
PubMed1976

[Corneal lesion by vacuum extraction (author's transl)].

The case of a 6-year-old boy is reported who was delivered out of a frontal position by application of the vacuum cup to the left part of the forehead. His left eye exhibits a pronounced somewhat irregular astigmatism. There are some vertical descemet tears. Because of the application of the vacuum pump close to the left bulbus, an increase of the tissue tension and consequently a deformation of the bulbus occurred by the vacuum in the bulbar region. The described lesions parallel the vertical descement tears which occur in forceps-delivery. Owing to the greater horizontal corneal diameter, a more pronounced extension of the cornea in the horizontal meridian occurs, which would explain the vertical course of the descemet tears. The obstetric contraindication for the application of the vacuum extraction in case of a frontal or facial position of the fetus is justified also from the ophthalmological point of view because of the risk of occurrence of irreversible corneal lesions.

Astigmatism↗
PubMed1983

Portsmouth operative delivery trial: a comparison vacuum extraction and forceps delivery.

A total of 304 women, for whom operative delivery was considered necessary in the second stage of labour, were randomly assigned to delivery by vacuum extraction or forceps. Of those allocated to forceps a higher proportion of babies were actually delivered with the allocated instrument; however, the caesarean section rate was also higher in this group. Maternal trauma, use of analgesia and blood loss at delivery were significantly less in the group allocated to vacuum extraction. Vacuum extraction did, however, appear to predispose to an increase in mild neonatal jaundice. More serious neonatal morbidity was rare in both groups and the trial was of insufficient size to rule out a clinically important differential effect of the two instruments on these measures of outcome. Another trial is now needed to address this still open question more rigorously.

Adult↗