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Vacuum Delivery

Powerpoint presentation on assisted vaginal delivery using vaccum

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Ouma Ogombo
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86 views12 pages

Vacuum Delivery

Powerpoint presentation on assisted vaginal delivery using vaccum

Uploaded by

Ouma Ogombo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Vacuum

delivery
Indications
 Maternal Benefit – shorten the 2nd stage of labor
 Ex: maternal cardiac conditions/history of aneurysm/stroke
 Fetal benefit - concern for immediate/potential
fetal compromise
 Ex: Prolonged terminal bradycardia
 Prolonged 2nd stage
 Nulliparous = No progress for 2 hrs
 Multiparous = No progress for 1 hrs
Before attempting a
vacuum delivery, you
should know…
 Presentation
(Cephalic/Breech)
 Position (i.e. occiput posterior,
occiput anterior)
 Lie (longitudinal, oblique,
transverse)
 Station
 Clinical pelvimetry
Contraindications

 Gestational age < 34 weeks


 Risk of fetal IVH (intraventricular hemorrhage)
 Known bleeding disorder
 Fetal head unengaged
 Position of fetal head unknown
Vacuum assisted vaginal
delivery – types of
vacuum
Step by step…
 OBTAIN CONSENT!
 Empty the bladder
 Determine position of the head
 Insert the cup into the vaginal vault, ensuring that no maternal tissues are
trapped by the cup
 Apply the cup to the flexion point 3 cm in front of the posterior fontanel,
centering the sagittal suture
 Pull during a contraction with a steady motion
 Watch the suction gauge (ensure you are in the green zone!)
 Traction is repeated with each contraction until the head is crowned
 As the head clears the pubic symphysis, the vertex is pulled upward at an angle
of 45 degrees to the floor
 Once the head is delivered, suction is released, and the cup is removed
 Delivery then proceeds as usual
Warnings  Should not be attempted for more than
20 minutes.
 Should be abandoned if no progress is
made after 1-2 pulls
 Should be abandoned after three cup
detachments
 Should also be stopped if there is any
evidence of fetal scalp trauma
Fetal Risks – 5% chance of complication

 Scalp lacerations
 Cephalohematoma
 Subgaleal hematoma
 Intracranial/retinal hemorrhage
 Hyperbilirubinemia/jaundice
Cephalohematoma

Subgaleal hematoma
Subgaleal hematoma

 Most serious fetal complication associated with vacuum assisted delivery


 Occurs in less than 1% of VADs
 Clinical presentation:
 Boggy scalp
 Swelling crossing the suture lines
 Expanding head circumference
 Signs of hypovolemia, pallor, tachycardia and a falling blood count
THE END

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