Indications and contraindications for fetal vacuum extraction
Last reviewed: 23.04.2024
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Indications for fetal vacuum extraction:
- steady low transverse standing of the swept seam;
- incorrect insertion of the head (asynclitism, rear view of the occipital presentation, etc.);
- lack of progressive advancement of the head through the birth canal, as the most frequent indication;
- extragenital diseases of a pregnant woman (cardiovascular diseases, pulmonary diseases) with inadmissibility of pressure on the abdominals;
- shortening of the second stage of labor;
- protracted II period of labor in combination with distress (suffering) of the fetus;
- a short period of childbirth;
- fetal distress - in cases where the operation of the vacuum extraction of the fetus can be carried out faster than a cesarean section;
- shortening of the second stage of labor as a method for improving the state of the fetus;
- umbilical cord loops;
- removal of the head through the incision of the uterus during cesarean section;
- weak labor;
- weak labor and the threat of asphyxia;
- weak labor activity, endometritis in childbirth, the threat of fetal asphyxia;
- started fetal asphyxia;
- severe forms of late toxicosis - eclampsia, preeclampsia;
- pronounced psychomotor agitation of a woman in labor in the second stage of labor;
- narrowing the size of the exit from the pelvis;
- premature detachment of the placenta;
- other internal pathology.
Thus, the indications for carrying out the operation of vacuum extraction of the fetus are all the states of the mother and the fetus, requiring more rapid delivery in the interests of their health and life.
Contraindications to the operation of the vacuum extraction of the fetus
There are absolute and relative contraindications.
Absolute contraindications:
- discrepancy between the size of the pelvis and the head of the fetus;
- facial presentation;
- pelvic presentation;
- congenital malformations;
- dead fetus
Relative contraindications:
- premature birth - premature baby;
- distress fetus with high acidosis in him according to the acid-base state;
- incomplete disclosure of uterine throat;
- high head;
- after Zalinga’s test (blood sampling from the tissue of the presenting part, in particular, the fetal head).
With proper consideration of the indications and accurate performance of the technique of operation, vacuum extraction is not dangerous for the fetus. Terms of operation:
- an objective assessment of the condition of the fetus before the operation;
- accurate knowledge of finding the head in the pelvis;
- use only a large cup of vacuum extractor;
- sufficient time to create an optimal negative pressure (on average from 4 to b min);
- Preventing cupping of the head from the fetus.
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