vacuum extractors

Question 1

prerequisites for us of vacuum

Answer 1

Term infant (need head to be calcified completely)
Vertex presentation (appropriate suction)
Engagement of fetal head to +3 station
Ruptured membranes
Full cervical dilation
Minimal CPD

Question 2

contraindications for vacuum

Answer 2

Moderate to severe CPD
Breech
Transverse face or brow presentation
Incomplete cervical dilation
Prematurity
Unengaged head

Question 3

indications for vacuum

Answer 3

persistant OP
asynclitic vertex position
exhausted mother
fetal distress- where it is more advantageous to deliver quickly than to transport

Question 4

maternal complications

Answer 4

vaginal lacerations

Question 5

fetal complications

Answer 5

Scalp abrasions
Bruising, cephalohematoma, subaponeurotic hemorrhage
Jaundice as side effect of the excessive bruising and complications above
Low APGAR scores; be ready to resuscitate when using vacuum, as it seems to take these infants longer to start breathing.
Cranial fracture
Death

Question 6

indications to discontinue use of vacuum

Answer 6

Disengagement of vacuum cup due to excessive force needed to move the head (this is a warning of CPD and you need to question if you can get the shoulders out even if you move the head).
Failure to deliver the head 10 accrued minutes of vacuum use at maximum negative pressure (while contracting)
Failure to deliver the head after 30 minutes total of vacuum use
Only 2 “pop offs” allowed