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Vacuum Assisted Delivery

See Also
1. Forceps Assisted Delivery
Precautions
1. Vacuum can do as much or more damage as forceps
2. Criteria to discontinue (prevent Subgaleal Hemorrhage)
  1. No progress after 3 pulls
  2. No baby extraction in 30 minutes after initiation
  3. Cup disengages 3 times
  4. Significant fetal scalp or maternal trauma
Preparation
1. See Preparation for Assisted Delivery
Technique
1. Apply Suction cup during contraction
2. Decrease cup pressure to 100 mmHg between contractions
3. No traction until cup pressure >400 mmHg
4. Gentle steady traction during contraction only
  1. Maintain pressure of 400 to 600 mmHg
5. Apply one hand on vacuum traction handle
  1. Apply other hand on cup and fetal presenting part
  2. Maintain suction seal
  3. Assist slight posterior direction
  4. Prior to clearing pubic symphysis
6. Episiotomy at crowning as needed for Fetal Distress
7. Remove cup at crowing as mandible presents
8. Perform a thorough exam of mother and baby

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This page was written by Scott Moses, MD. This page was last revised on 5/12/2008 9:45:30 PM. This page was last published on 6/1/2008. 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.