ABSTRACT
A prospective study was designed to determine the effectiveness and safety of different types of vacuum extraction cups. Northern Area Armed Forces Hospital, Saudi Arabia. We randomized 118 women, for whom instrumental vaginal delivery was decided, to vacuum extraction with the conventional metal cup or the Silastic, silicon pliable rubber cup. Delivery was completed with the silicon rubber cups in 77% of cases, while with metal cups there was a 80.7% success rate [p > 0.05]. However, there was a statistically significant greater incidence of maternal tissue injuries, extension of episiotomies, pelvic infection and fall of haemoglobin with the use of the metal cup vacuum extractor compared with the silicon cup extractor. There was a significant increase in neonatal morbidity for the metal cup group compared with silicon cup delivery especially scalp trauma and cephalohaematomata. There were no significant differences in the Apgar score, neonatal jaundice, and umbilical artery pH between the metal cup and the silicon cup vacuum extractors. We conclude that the use of the silicon vacuum extractor should be encouraged to replace metal cups, as the data of the present study indicated that the use of silicon rubber cups to effect delivery had a greater success rate than metal cups with significantly less maternal and neonatal morbidity