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Preparation for Assisted DeliveryAka: Assisted Delivery, Assisted Delivery Complications

Indication
1. Preparation for Forceps Assisted Delivery
2. Preparation for Vacuum Assisted Delivery
Complications
1. Maternal: Third and fourth-degree Lacerations
  1. Spontaneous Vaginal Delivery: 1.7%
  2. Vacuum extraction: 9.3% risk
  3. Forceps delivery: 19.2% risk
2. Fetal
  1. Retinal hemorrhage: Odds Ratio 2.0 higher risk with vacuum more than forceps
  2. Cephalohematoma: Odds Ratio 2.4 higher risk with vacuum more than forceps
  3. Subgaleal Hemorrhage
Technique: (Mnemonic - ABCDEFGHIJ)
1. Anesthesia adequate?
2. Bladder empty?
3. Cervix Completely dilated?
4. Determine head position (think dystocia)
5. Equipment ready?
  1. Confirm that forceps interlock
  2. Test suction on Vacuum
  3. Replace Scalp Electrode with External Fetal Monitor
6. Fontanelles ascertained (Position for safety)
  1. Position
    1. Position anterior to Posterior Fontanelle by 1 cm
  2. For
    1. Fenestrations (very little of hole palpable)
  3. Safety
    1. Sagittal Suture in line with forceps
7. Gentle steady traction (Pajot's Maneuver)
  1. Vacuum should only be applied during contraction
8. Halt between contractions
9. Incision or Episiotomy
10. Jaw seen (remove Forceps or suction)

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This page was written by Scott Moses, MD. This page was last revised on 1/3/2009 8:36:19 PM. This page was last published on 2/26/2010. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.