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A baby's scalp showing the effects of a vacuum extraction (chignon). The effects were gone a week later.

Ventouse is a vacuum device used to assist the delivery of a baby when labour has not progressed adequately. It is an alternative to a forceps delivery and caesarean section. It is not usually used when the baby is in the breech position or for premature births. This technique is also called vacuum-assisted vaginal delivery or vacuum extraction (VE). The use of VE is generally very safe, but can rarely have negative effects on both the mother and the child.[1]

Contents

Technique

The woman is placed in the lithotomy position and assists throughout the process by pushing. A suction cup is placed onto the head of the baby and the suction draws the skin from the scalp into the cup. Proper placement is critical to keep the head flexed, thus the cup is placed on the flexion point, about 3 cm anterior from the occipital (posterior) fontanelle. Ventouse devices have handles to allow for traction. When the head is born the device is detached, allowing the woman to complete the delivery of her child.

Generally the cervix has to be fully dilated, the head engaged, and the head position known to allow for a proper use of the ventouse. If the ventouse attempt fails it may be necessary to deliver the infant by caesarean section.

Indications for use of vacuum

There are three generally accepted indications to use a ventouse to aid delivery:

  • Prolonged pushing in the second stage of labor or maternal exhaustion
  • Fetal emergency in the second stage of labor, generally indicated by changes in the fetal heart rate
  • Maternal illness where "bearing down" or pushing efforts would be risky (e.g. cardiac conditions, blood pressure)

Comparisons to other forms of assisted delivery

Positive aspects

  • An episiotomy is not usually required and there is little internal bruising.
  • The mother still takes an active role in the birth.
  • No special anesthesia required.
  • The force applied to the baby can be less than that of a forceps delivery, leaving no marking on the face.
  • Less potential for maternal trauma compared to forceps and cesarean section.

Negative aspects

  • The baby may be left with a temporary lump on its head, known as a chignon.
  • A possible cephalohematoma formation, or subgaleal hemorrhage.

External links

References








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