Vaccuum or Forceps

Question 1

What stage interventions are vaccuum and forceps

Answer 1

Second stage (maybe just when this starts?)

Question 2

What type of pressure is used when the vacuum suctions the fetus head?

Answer 2

negative pressure

Question 3

Which one is done first and is easier to use? Vacuum or forceps

Answer 3

Vaccume come first and is easier

Question 4

A baby who needed a vacuum has an enlarged, molded head. What do you tell the parents

Answer 4

Tell them this is normal for the procedure and will go away in 3-5 days

Question 5

What happens if vacuum is left too long on baby head?

Answer 5

Cephalhematoma (blood)

- this in turn increases risk of jaundice due to rbc spilling outside the vessel and being destroyed

Question 6

What are forcep assisted births like?

Can the woman push at the same time?

Answer 6

The curved forceps are put around baby’s head to help pull them out

Yes she can push with contractions

Question 7

Forcep applications : Outlet

Answer 7

Outlet or when fetal skull is at the perineum where the scalp is visible
- safest option

Question 8

Forcep applications: Low

Answer 8

Skull is past the a 2+ station at least

Question 9

Forcep applications : Mid pelvis

Answer 9

Applied after fetal head is engaged and passed zero station, but above +2 station.
- not recommended anymore

Question 10

Why would you use a vacuum or forcep

Answer 10

Any condition that threatens mom or fetus that can be relieved by a faster birth

• heart disease
• maternal conditions
• analgesia or anesthesia that diminishes the ability to push
• Placental seperation or abruptio
• Non-reassuring fetal status

Question 11

Pre-requisites for forceps or vacuum:

From mom?

From practitioner?

For pain?

For safety? (5)

Answer 11

Consent from mom

A skilled provider

Anesthesia for comfort and pain

Cervix must be completed dilated and effaced
Make sure to know infant positioning is cephalic
Know station as well
Ruptured membrane and empty bladder
No CPD or head being too big for the pelvis

Question 12

Nursing role during forceps or vacuum procedure

Inform?
Educate?
Assess?

Answer 12

Inform patient and provide support

Educate them that they may feel pressure but no pain if blocked

Assess FHR by continuous electronic fetal monitoring
- check for decels or bradycardia specifically

Question 13

Neonate risks of using forceps or vacuums

Answer 13

Facial edema and ecchymosis

Lacerations of face and scalp

Caput succedaneum
Cephalhematoma > jaundice

Face paralysis that is transient/short term

Subdural hematoma (of the eye i think)

Question 14

Maternal risks of using forceps or vaccums

Answer 14

Lacerations of vagina or extensions
Increased blood loss 
Hematoma formation
Birth canal bruises
Perineal edema
Infection