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Vacuum-Assisted Birth
Description
Vacuum-assisted birth is a method of assisting or expediting vaginal vertex birth through the application of a vacuum-assist device. Operative vaginal birth can be faster and safer than cesarean birth in many cases. Discussion here is limited to vacuum-assisted births with the fetus presenting within 45 degrees of directly occiput anterior.
Indications
Fetal —nonreassuring fetal status, acute fetal distress. Maternal —fatigue, prolonged second stage of labor (nulliparous women: Lack of continuing progress for 3 hours with regional anesthesia or 2 hours without regional anesthesia; multiparous women: Lack of continuing progress for 2 hours with regional anesthesia or 1 hour without regional anesthesia), certain types of pulmonary, cardiac, or neurologic diseases that preclude pushing.
Contraindications
Incompletely dilated cervix, significant fetal malpresentation, unengaged fetal head, intact fetal membranes, inability to assess fetal position or obtain maternal cooperation, distorted or contracted maternal pelvic anatomy, gestational age less than 34 weeks, fetal demineralization or clotting disorder, prior scalp sampling, or multiple attempts at fetal scalp electrode placement (relative).
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