The Vacuum Extractor and Forceps in Obstetrics A Clinical Study

Fetal and maternal effects of forceps and vacuum extraction

“…Forceps delivery has come back and its use has gradually increased. Studies comparing forceps and vacuum extraction usually show that vacuum extraction is more advantageous for both infant and mother (Sjostedt 1967 ; Greis etal. 1981).…”

“…In some studies, almost identical fetal complications have been found after delivery by forceps as after vacuum extraction (Schenker & Seer 1967), and there were no differences in neonatal acid-base balance (Livnat et al 1978). Most comparative studies, however, have suggested the advantages of vacuum extraction for both the infant and the mother (Sjostedt 1967;Chiswick & James 1979;Greis et al 1981). In a recent follow-up study of adults who were born either by forceps or vacuum extraction, paradoxically, those born by forceps has a significantly higher mean intelligence quotient than those born by vacuum extraction and also higher than the national average (Nilsen 1984).…”

Uterine Rupture and Vacuum Extraction

“…These fi gures sho w tha t ute rine rupture a ppears to be uncommo n with vacuum extractions. Some facto rs inhe re nt in the instrume nt a nd its mecha ni sm possibly contribute to this record of safe ty, na mely the sma ll size of the c up a nd its application on th e top of the vertex with its limited traction fo rce ( 12). Moreover , with the vacuum extractor minimal manipula tion s a re usua ll y need ed to apply the c up a nd ac hie ve d eli very even in cases of pe rs istant occipitoposte ri or o r occipitotra nsverse positions as the re is no need for di simpaction or ma nua l rotation of th e fetal head (1 , 8).…”

“…Sta ti s ti cs indi cate tha t with th e u se of the cacuum extractor, the fre que ncy of ma terna l injuries a nd complications of deliv e r~ h~ve c?ncomitan tl y decreased a nd tha t th e lymg-m pe nod is the sam e as with normal la bour (3,7,10). This, ho wever, does not indicate tha t th e vacuum extractor is a ha rmless ins trume nt , for its u se can be ass ocia ted w ith perineal , v agina l a nd cervical lace ra tions, the frequency of whic h d epe nd s la rgely on selection of cases, experience and dexteri ty of the operator a nd whethe r or not the examiner searches for postopera tive injury (12).…”

Commentary on ‘Maternal and child health after assisted vaginal delivery: five‐year follow up of a randomised controlled study comparing forceps and ventouse’

“…As early as 1890 McCahy argued that ventouse was much safer than forceps because the amount of traction which could be applied was limited by the vacuum. 2 The first randomised trial of forceps versus ventouse was published in 1964, 3 and in 1967 there was extensive correspondence in the British Medical Journal discussing the relative indications and merits, with one author commenting that 'the final decision as to instrument should depend on the obstetrician's experience, enthusiasm and considered results'. 4 Since this time the literature on the topic has grown, and the debate has continued, with the vast majority of the literature reporting immediate outcomes.…”