Vacuum extraction delivery.

Question 1

CONTRAINDICATIONS OF VENTOUSE?

Answer 1

Any presentation other than vertex

< 34 weeks

Chance of scalp avulsion or subaponeurotic hemorrhage

suspected fetal coagulation disorder

suspected fetal macrosomia (≥ 4 kg)

Question 2

Advantages of Ventouse Over Forceps?

Answer 2

It can be used in unrotated or malrotated head It helps in autorotation

„Traction force is less compared to forceps

has lower rates of maternal
trauma and genital tract lacerations

Analgesia need is less

THATS THIS IS THE FIRST OPTION

Question 3

procedure

Answer 3

Pudendal block

the fetal position and station is assessed and determined with two internal fingers the middle and index the flexion point is located - determine the length from the flexion point where the middle finger is placed to the the end of the perineum where the finger lies

The largest possible cup is to be selected.

place one hand or two in the vagina and pull down the perineum so you can slide the cup sideways

The cup is introduced pulling the perineum down with two fingers on the vagina of the other hand.

The cup is placed on the sagittal suture

now move the cup to the amount of cm you determined from flexion pint to the perineum
by one index finger into the anterioir part of the vaigina pulling it up and the the other index finger at the superior margin of the cup and pulling it down to the flexion point

stabilised the cup with the superior index finger than was holding the vagina

A check is made using the fingers round the cup to ensure that no cervical or vaginal tissue is trapped inside the cup

The then the vacuum is is placed to the cup

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traction made through the axis of the pelvic plane

place one thumb one the cup and the index finger on the baby’s head to prevent that cup from coming off and to note to note the correct angle of traction, rotation and advancement of the head

Traction should be synchronous with the uterine contractions

Traction is released in between uterine contractions

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As soon as the head is delivered, the vacuum is reduced

Question 4

where is the flexion point ?

Answer 4

located midsagittally about 6 cm from the center of the anterior fontanel or about 3 cm in front of the posterior
fontanel.

Question 5

prerequisite for vacuums extraction ?

Answer 5

same as forceps

there needs to be full cervical dilation
the fetal head needs to be engaged
fetal head position and station needs to be known
there is emptying of bladder
analgesia is offered
good uterine contraction
no cephalopelvic disproportion
membrane is ruptured
epstiotomyif done when there is crowing of the head
head in vertex