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At least 19 recordsLinked to original sources
PubMed1991

[A fetal extraction device used in under-equipped countries: the obstetrical vacuum extractor. Results of 393 vacuum extractions in the Maternity Hospital in Sélestat. (Reflections on the use of this device in African practice)].

The level of mortality and feto-maternal morbidity in under-equipped countries is frightening. It is important to find answers. Among these: the obstetrical Ventouse is an instrument that can be used for extracting the fetus without too much difficulty. It is relatively easy to learn and to apply as compared with forceps (so long as the mechanism by which it is used is understood). The conditions under which it can be used are well defined at present: term pregnancy, the woman must be in labour, fetal membranes must be ruptured, the cervix must be completely dilated, presentation must be cephalic and the head must be engaged. 393 Ventouse extractions were carried out between 1982 and 1988 at the Maternity Hospital of Selastat and this resulted in delivery of 393 infants in good health. No maternal or fetal mortality occurred in the series. The maternal morbidity was low at 0.76% and the fetal morbidity was only 4.7%. In view of our experience, we believe that the tendency for black women to have android pelves makes it preferable to use the Ventouse as against the forceps because it has several advantages. In view of the literature and of their practice, the authors advise that the obstetric Ventouse should be used in under-equipped countries where conditions of practice are often precarious and the team poorly qualified. This will reduce the mortality and morbidity due to delivery. Pregnant women are insufficiently educated. The quality of health personnel is inadequate. The health services are inadequate for the needs of the population.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Perinatal audit of one hundred consecutive vacuum extractions in Maputo.

The extraordinary demands on obstetrical services that prevail in many developing countries necessitate critical reviews of existing norms for obstetrical management. Vacuum extractions were studied in this context as a part of the regular perinatal audit carried out at the Maputo Central Hospital, the only hospital in Maputo with emergency surgery catering to the 43,000 annual deliveries. Extractions performed with the fetal head above the ischiatic spines were associated with a high number of complications and an 81% risk of neonatal asphyxia and also with a number of severe neonatal traumas. The risk of intracranial hemorrhage tended to be higher with extractions of fetuses with the head at or above the ischiatic spines, particularly when there was concomitant intrapartum asphyxia. It is concluded that a frequent perinatal audit of selected risk deliveries is a useful monitoring tool for examining prevailing indications for various obstetric interventions.

Asphyxia Neonatorum↗
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↗
PubMed1978

Neonatal acid-base balance in spontaneous and instrumental vaginal deliveries.

The acid-base balances of 63 neonates delivered either spontaneously or by the vacuum extractor or low forceps were compared. The outcome was similar in neonates delivered by vacuum extractor or forceps. However, significant differences were noted in the pH and base deficit of infants born by instrumental versus spontaneous delivery. These differences were no longer present when groups with similar duration in the second stage of labor were compared. We conclude that the use of instruments for outlet vaginal delivery carries no additional risk for the fetus.

Acid-Base Equilibrium↗
PubMed1991

A randomized comparison of assisted vaginal delivery by obstetric forceps and polyethylene vacuum cup.

The assisted vaginal delivery methods of rigid obstetric forceps and polyethylene vacuum cup extraction were compared in a prospective, randomized study. The 99 women studied had all completed 35 full weeks' gestation, required attempted assisted vaginal delivery, and were randomly assigned to either attempted forceps or vacuum-assisted delivery. All presentations were cephalic, with stations ranging from +1 to +4. Neonates were evaluated at 24 hours by neonatal staff. The infants underwent intracranial ultrasound screening during the first 24 hours of life and ophthalmologic examination within 48 hours. Vaginal delivery was successful with the intended method in 83% of vacuum-assisted deliveries and in 78% of forceps deliveries (not statistically significant). Neonatal retinal hemorrhage was found in 17 and 38% (P less than .043) of the randomized forceps and vacuum deliveries, respectively. No intraventricular hemorrhage was found. Apart from associations between vacuum-assisted delivery and mild hyperbilirubinemia and neonatal retinal hemorrhage (of uncertain clinical significance), and between assisted forceps delivery and an increased potential for facial injury, neonatal outcomes did not differ significantly. Maternal outcomes also did not differ significantly. No significant differences in safety or efficacy were found between polyethylene cup vacuum extraction and rigid obstetric forceps-assisted vaginal delivery in this population of predominantly low-pelvic assisted deliveries. Patients delivered by sequential use of forceps after vacuum or by vacuum after failed forceps application did not suffer significantly increased morbidity relative to those delivered by forceps or vacuum alone. Use of alternate or sequential methods allowed an overall cesarean rate of 3% in this population.

Acid-Base Equilibrium↗