Parto vaginal operatório / Operative vaginal delivery

PONTOS-CHAVE Quando utilizados na técnica correta, fórcipes e vácuo-extratores apresentam baixos índices de complicações. Para o feto com sinais de hipóxia no período expulsivo, o parto vaginal operatório tem potencial para reduzir a exposição aos fatores intraparto que promovem a encefalopatia hipóxico-isquêmica. Fórcipes médios e/ou rotacionais são opções apropriadas em circunstâncias selecionadas e exigem habilidade e experiência. Os fórcipes são mais resolutivos do que os vácuo-extratores para o parto vaginal operatório, porém são mais associados a lacerações perineais graves. Céfalo-hematoma é mais provável de ocorrer com o aumento na duração da vácuo-extração. Os vácuo-extratores de campânulas flexíveis apresentam taxas maiores de falha, porém apresentam menores incidências de trauma no couro cabeludo do neonato. (AU)

Operative vaginal delivery: practice patterns and outcomes at a tertiary general hospital

INTRODUCTION@#There has been a global decrease in operative vaginal deliveries, with a marked shift towards the vacuum extractor. However, little is known about the trends in operative vaginal delivery in Singapore.@*METHODS@#A retrospective study was conducted on all operative vaginal deliveries performed from 2012 to 2017 at Singapore General Hospital (SGH). Maternal outcomes in terms of postpartum haemorrhage and obstetric anal sphincter injuries were compared between forceps- and vacuum-assisted deliveries. Neonatal outcomes in terms of neonatal intensive care unit (NICU) admission and clinically significant neonatal events were compared. The instrument preference of obstetricians was analysed.@*RESULTS@#A total of 906 consecutive operative vaginal deliveries were included in the study, comprising 461 forceps- and 445 vacuum-assisted deliveries. The rate of operative vaginal delivery was maintained at approximately 10% from 2012 to 2017. Neonatal cephalohematomas were more common after vacuum-assisted deliveries. Other maternal and neonatal outcomes did not differ significantly between the two groups. Clinically significant neonatal events were mostly due to shoulder dystocia, whereas all cases of NICU admissions were not directly related to the mode of delivery. Obstetricians' choice of instrument appeared to reflect personal preference and was not affected by the year of graduation.@*CONCLUSION@#The rates of neonatal and maternal morbidity were low at SGH. Overall instrument use of forceps and vacuum was balanced, and proficiency in both was demonstrated by all operators. Operative vaginal delivery remains an essential skill in facilitating safe vaginal delivery, which should be maintained to keep Caesarean section rates in check.

The clinical characteristics and prognosis of subgaleal hemorrhage in newborn / 소아과

PURPOSE: Subgaleal hemorrhage (SGH) is a rare but potentially fatal condition in newborns; however, few studies have reported on this condition. We aimed to identify the clinical characteristics and prognostic factors of SGH. METHODS: We retrospectively reviewed the medical records of 20 neonates diagnosed with SGH between January 2000 and June 2017. Enrolled neonates were clinically diagnosed when they had tender fluctuant scalp swelling that crossed the suture lines. RESULTS: Among 20 neonates with SGH, 12 were boys and 7 were girls; median hospitalization duration was 9.7±6.9 days. Fourteen neonates (70%) were born via vacuum-assisted vaginal delivery, and 4 via vacuum-assisted cesarean section. Of the neonates enrolled, half of them initially showed unstable vital signs, including apnea, desaturation, and cyanosis. Ten neonates had acidosis and 3 had asphyxia (pH < 7.0). Intracranial lesions associated with SGH were observed in 15 neonates (75%), including subdural hemorrhage (50%), subarachnoid hemorrhage (15%), intraventricular hemorrhage (5%), cerebral infarct (15%), skull fracture (30%), and cephalohematoma (20%). Twelve neonates (60%) required transfusion, 5 (25%) had seizures, and 3 (15%) died. Eight neonates (40%) had hyperbilirubinemia (mean total bilirubin, 13.1±7.4). The mean follow-up period was 8.4±7.5 months. At follow-up, 10 neonates (58.8%) were healthy with normal development, whereas 7 (41.2%) had neurological deficits. CONCLUSION: The morbidity rate was 41.2% due to severe metabolic acidosis. Anemia, hyperbilirubinemia, low Apgar scores, and subdural hemorrhage did not affect the prognosis. The long-term outcomes of neonates with SGH are generally good. Only arterial blood pH was significantly associated with death.

Embarazo ectópico cervical / Cervical Ectopic Pregnancy

El embarazo ectópico cervical es la implantación del huevo fertilizado a nivel del orificio cervical interno o por debajo de este. Se describe un caso de embarazo ectópico cervical en una paciente de 43 años con historia obstétrica de tres gestaciones, un parto por cesárea hace 19 años y un aborto provocado. El embarazo ectópico cervical representa 0,1 por ciento de los embarazos ectópicos y su diagnóstico se realiza a través de criterios clínicos, ultrasonográficos y anatomopatológicos específicos. En mujeres en edad fértil que asisten a consulta por sangrado vaginal o dolor abdominal, siempre hay que tener presente esta afección, en especial si presentan factores de riesgo. Su manejo está estrechamente relacionado con la edad gestacional, condiciones clínicas y paridad de la paciente. Actualmente su tratamiento es controvertido por su poca frecuencia. La conducta es emergente en casos complicados pues la hemorragia puede conducir a la muerte materna(AU)

Cervical ectopic pregnancy is the implantation of embryo at the cervical internal hole or below. Case report: A case of cervical ectopic pregnancy is described in a 43-year-old patient with obstetric history of three gestations, one childbirth by means of cesarean surgery 19 years ago and one induced abortion. The cervical ectopic pregnancies represent 0,1 percent of ectopic pregnancies and its diagnosis is carried out through clinical exam, ultrasonography and specific anatomic pathological approaches. When treating childbearing-age women who attend consultation due to vaginal bleeding or abdominal pain, doctors must always keep in mind this condition, especially if they have risk factors. The management of this condition is closely related with the gestational age, clinical conditions and the patient's parity. Its treatment is now controverted since it is rare. The medical action is emergent in complicated cases, because hemorrhage can lead to mother´s death(AU)

Vacuum extraction vaginal delivery: current trend and safety

Operative vaginal birth retains an important role in current obstetric practice. However, there is an increasing trend in the rate of cesarean section in Korea. Surgical delivery is more advantageous than cesarean section, but the rate of operative vaginal delivery is decreasing for various reasons. Furthermore, there is no unified technique for vacuum extraction delivery. In this context, this review was performed to provide details of the necessary conditions, techniques, benefits, and risks of operative vaginal delivery. Future research should focus on overcoming the limitations of operative vaginal delivery.

Comparison of neonatal outcomes and intrapartum events in full term vaginal deliveries conducted by staff versus resident physicians

OBJECTIVE: The objective of this study was to compare the neonatal outcomes and intrapartum events conducted by staff versus resident physicians in full term vaginal deliveries. METHODS: We divided study population (n = 5,007) into two groups: staff versus resident physicians. These two groups were sub-divided; faculty versus fellow and senior versus junior resident, respectively. The maternal characteristics, neonatal outcomes including Apgar score, admission to the neonatal intensive care unit and umbilical arterial pH and intrapartum event which was defined as the occurrence of shoulder dystocia and vacuum delivery were also investigated. RESULTS: There was no difference in neonatal outcomes between two groups. The group delivered by staff had a higher rate of nulliparity, large for gestational age and intrapartum events than the resident physician group. The subgroup analysis revealed a higher rate of vacuum delivery in the group delivered by faculty and senior members than the group delivered by fellows and junior members. CONCLUSION: There was no significant difference in neonatal outcomes between the two groups; staff versus resident physicians in full term vaginal deliveries in low-risk pregnant women. Also, experienced obstetricians might tend to participate in difficult labors and would prefer applying vacuum compared to the obstetricians with fewer experiences.

Aspiração manual intrauterina no tratamento do abortamento incompleto até 12 semanas gestacionais: uma alternativa à curetagem uterina / Manual vacuum aspiration uterine treatment of incomplete abortion to 12 gestational weeks: an alternative to curettage

OBJETIVO: Analisar a eficácia e a ocorrência de complicações, além do tempo de permanência hospitalar e as perdas sanguíneas. MÉTODOS: Trinta pacientes foram selecionadas, alternada e consecutivamente, em um dos grupos (15 no Grupo Curetagem e 15 no Grupo de Aspiração manual intrauterina). As variáveis analisadas foram: eficácia do método, ocorrência de complicações, tempo pré-procedimento, tempo de execução do procedimento, tempo pós-procedimento e tempo total de permanência hospitalar, além de hematócrito e hemoglobina, medidas antes e após o procedimento. As pacientes foram avaliadas clinicamente 10 a 14 dias após o procedimento. Para a análise estatística, foram aplicados testes paramétricos e não-paramétricos e o nível de significância admitido foi de p>0,05. RESULTADOS: Ambos os métodos foram eficazes e não foi registrada nenhuma complicação. As perdas sanguíneas foram semelhantes e o tempo de permanência hospitalar foi significativamente menor no Grupo de Aspiração Manual Intrauterina (p=0,03). CONCLUSÃO: a aspiração manual intrauterina é tão eficaz e segura quanto à curetagem uterina, com a vantagem de necessitar menor tempo de permanência hospitalar, o que aumenta a resolutividade do método, melhorando a qualidade da assistência a essas pacientes.

PURPOSE: To analyze the effectiveness and occurrence of complications, in addition to hospitalization time and blood losses. METHODS: Thirty patients were assigned alternatively and consecutively to one of two groups (15 to the Curettage Group and 15 to the Manual Vacuum Aspiration Group). The following variables were analyzed: effectiveness of the method, occurrence of complications, time before the procedure, time of execution of the procedure, time after the procedure, and total time of hospital permanence, in addition to hematocrit and hemoglobin, which were measured before and after the procedure. Patients were evaluated clinically 10 to 14 days after the procedure. Parametric and nonparametric tests were used for statistical analysis, with the level of significance set at p>0.05. RESULTS: Both methods were efficient and no complications were recorded. Blood losses were similar in the two groups, but the hospitalization time was significantly shorter for the Manual Vacuum Aspiration Group (p=0.03). CONCLUSION: Manual vacuum aspiration is as efficient and safe as uterine curettage, with the advantage of requiring shorter hospitalization, which increases the resolution of the method, improving the quality of care for these patients.

Neonatal outcome with instrumental vaginal delivery: a study at PNS Shifa

To evaluate neonatal outcome in terms of Apgar score after forceps and ventouse delivery in pregnant ladies indicated to have instrumental deliveries. Randomized control trial. This study was conducted at Labor ward of department of obstetrics and gynecology, PNS SHIFA Karachi, between Dec 2007 to Mar 2008. The target population were all pregnant subjects who visited labor room for delivery. Out of these patients, subjects who were indicated an assisted vaginal delivery for necessary management of labor were formally requested to participate in the study after various exclusions. Instrumentation was done in only those patients with singleton term pregnancy with cephalic presentation and vertex at + 1 to +3 stations. Patients with an indication for assisted vaginal delivery [n=105], were randomized for ventouse [n=53] and forceps delivery [n=52]. Instruments used were Wrigley's outlet forceps and vacuum extractor [V.E] with silicone cups. Data was recorded on specially designed Proforma. Post delivery neonatal outcome in terms of Apgar score at one minute and five minutes were compared between two modalities. The subjects undergoing forceps delivery had a significantly higher Apgar score [8.36 +/- 1.27] at 1 minute in comparison to those subjected to vacuum delivery [7.53 +/- 1.56]. The differences in Apgar score at 5-minutes [forceps delivery: 9.136 + 1.01 vs vacuum delivery 9.00 + 1.19], were not statistically significant. Outlet forceps assisted vaginal deliveries had better neonatal outcome in terms of Apgar score in comparison to ventouse

Extração de feto grande pela manobra all-fours / Extration of large fetus through the all-fours maneuver

Introdução. A distocia de ombro é situação grave e imprevisível nos partos vaginais. Pode ser definida como impactação do ombro anterior contra o púbis materno que ocorre logo após a exteriorização da cabeça fetal. A manobra all-fours consiste em posicionar a parturiente de quatro, ou seja, movendo-a da sua posição litotômica dorsal para a posição de mãos-e-joelhos. Objetivo. Relatar experiência acerca do uso da manobra all-fours em feto grande, durante o parto, com intuito de oferecer aos profissionais de saúde maior compreensão e melhores condições de assistência às parturientes em situações de distocia de ombro. Caso. Parturiente, 32 anos, secundigesta, primípara, admitida no Hospital Regional da Asa Sul, com queixa de bolsa rota havia três horas e idade gestacional de quarenta semanas. História de parto normal na gestação anterior. Durante o período expulsivo, do segundo parto, tentou-se extrair o feto com manobras comuns, sem êxito. Diagnosticada, então, distocia de ombro grave. Foi decidido pela equipe executar a manobra all-fours, extraindo, em seguida, um feto vivo do sexo feminino, a termo, com Apgar 5-9, peso de 5.420 g. Conclusão. A manobra all-fours é segura, útil e eficaz quando realizada com técnica e, por ser relativamente nova na prática obstétrica, toda a equipe que atua em centros obstétricos deve conhecer sua indicação e seu manejo, para incrementar sua prática e evitar danos maternos e fetais nos casos de distocia de ombro.

Introduction. Shoulder dystocia is a serious, unexpected situation during the vaginal delivery. It can be defined as when the baby’s anterior shoulder gets stuck behind the mother’s pubic bone, after delivery of the fetal head. The all-fours maneuver consists of placing the expecting mother on her hands and knees, that is, moving from its dorsal lithotomy position for the hands-and-knees position. Objective. This work aims to report an experience of using the all-fours maneuver in large fetus during labor, in order to offer the health workers a better understanding and a better assistance to pregnant women presenting shoulder dystocia. Case. Woman in labor, 2nd gestation, 1 vaginal delivery, 32 years, admitted at Hospital Regional da Asa Sul referring fluid loss for three hours and with 40 weeks of gestation. During the delivery stage, we attempted to extract the fetus through the routine maneuvers without success. Then, it was diagnosed with severe shoulder dystocia. We were determined to perform the all-fours maneuver with the support of the team. Then, we extracted a live female fetus, at term, presenting Apgar 5-9, and weighing 5,420 g. Conclusion. The all-fours maneuver is safe, useful and effective when performed according to technique and, for being relatively new in the obstetric practice, the professionals who work at labor centers should be aware of the indications and the use of the maneuver, in order to improve the practice and prevent maternal and fetal injuries in cases of shoulder dystocia.

Frequency of second stage intervention and its outcome in relation with instrumental vaginal delivery versus caesarean section

To determine the frequency of second stage intervention and the risk of maternal and foetal morbidity and mortality associated with instrumental vaginal deliveries versus caesarean section in our tertiary care set up. This descriptive study was conducted in the Department of Obstetrics and Gynaecology [Unit-II] Liaquat University Hospital Hyderabad Sindh, Pakistan from January 2005 to December 2006. All the women who underwent instrumental vaginal delivery and caesarean section due to prolonged second stage of labour were included in this study. Data were collected on a pre-designed proforma, which included demographic details, maternal and perinatal morbidity as well as any complications etc. Finally, data were analysed through software program SPSS 10.0. Frequency of second stage intervention was 22.2%. Among, 400 women who undergone second stage intervention, 240 [60%] were delivered by caesarean section and 160 [40%] were delivered with the help of instruments. Majority of women, i.e., 49.25% were between 21-30 years of age, 73% were un-booked cases while 45% cases were primigravida. Complications with abdominal delivery were paralytic ileus in 35 [14.58%] cases, post partum haemorrhage in 30 [12.5%] cases and tear extension in 13 cases. Complications with instrumental delivery were vaginal tear in 28 [17.5%] cases, cervical tear in 12 [7.5%] and third degree perineal tear in 4 [2.5%] cases. The perinatal outcome with abdominal delivery [86.66%] was better as compared to instrumental delivery [72.5%]. The frequency of second stage intervention seems high in our set up and is associated with significant maternal and perinatal morbidity. Maternal morbidity was more frequent abdominal delivery while neonatal morbidity and mortality was more frequent with instrumental delivery

Novos aspectos da vácuo-extração fetal / New aspects of vaccum-extracted deliveries

Apresentamos um dispositivo descartável de manejo simples (Mityvac - Prism Healthcare, San Antonio, Texas) que, embora pouco difundido, já está disponível em alguns hospitais brasileiros e é devidamente licenciado pela Agência Nacional de Vigilância Sanitária (ANVISA). Sua aceitação na Inglaterra e Estados Unidos tem sido grande nos últimos 10 anos. Os principais tempos e cuidados no manuseio do equipamento são expostos

El uso de vacuum extractor disminuye la tasa de lesiones maternas severas asociadas al fórceps sin aumentar las complicaciones fetales severas / Vacuum extractor decrease of maternal morbidity rated without increasing perinatal morbidity

Antecedentes: Existe evidencia que sugiere que el método de elección para resolver un parto operatorio es el vacuum extractor, sin embargo, esta recomendación no se ha incorporado a la práctica habitual en América Latina. Objetivos: Comparar los resultados materno-fetales de la aplicación del vacuum o fórceps. Métodos: Revisamos los 12 estudios controlados y randomizados que comparan los resultados materno-fetales del uso de vacuum y fórceps, publicados hasta julio de 2006. Resultados: El vacuum como método primario es menos efectivo que fórceps en conseguir partos vaginales, sin embargo dado que permite el uso de fórceps secundario, presenta una menor tasa global de cesáreas. El vacuum extractor se asocia a una menor tasa de lesiones maternas severas, y a un aumento en la tasa de céfalo hematomas. No existen diferencias en la tasa de mortalidad perinatal ni de otras complicaciones fetales. Conclusión: El uso de vacuum se asocia a una menor morbilidad materna y a una mayor incidencia de céfalo hematoma, sin aumentar la mortalidad perinatal ni las complicaciones fetales severas.

Background: Today's evidence suggests the use of the vacuum extractor as the better method for assisted vaginal delivery; nevertheless, this recommendation has not impacted the usual practice in Latin America. Objectives: To compare the maternal-fetal outcomes associated to vacuum or forceps. Methods: We reviewed the 12 randomized controlled trials comparing the maternal-fetal outcomes of vacuum and forceps, published until July 2006. Results: The vacuum as a primary method is less effective than forceps in obtaining vaginal delivery; nevertheless, since secondary use of forceps is possible, vacuum exhibits a smaller global rate of caesarean section. The vacuum extractor is associated to a smaller rate of severe maternal injuries, and to an increased rate of cephalic hematomas. There are no differences in perinatal mortality or the rates of other fetal morbidity. Conclusion: The vacuum extractor is associated to a lower maternal morbidity and to a greater incidence of cephalic hematoma, without increasing perinatal morbidity and mortality.

Risk factors for hypoxic-ischemic encephalopathy in asphyxiated newborn infants.

OBJECTIVE: To determine the risk factors for hypoxic-ischemic encephalopathy (HIE) in asphyxiated newborn infants. MATERIAL AND METHOD: A retrospective study of 17,706 newborns, who were admitted to the Neonatal Unit of King Chulalongkorn Memorial Hospital, from July 1999 till the end of December 2000. 84 infants with perinatal asphyxia were enrolled in the present study. All of the possible risk factors that might have contributed to asphyxia were identified and recorded HIE was diagnosed based on the Modified Sarnat-Sarnat Score for the diagnosis of neonatal encephalopathy. The clinical data of the HIE group were compared with those of the HIE negative group. The categorical data were analyzed for statistical significance (p < 0.05) by Chi-square test or Fisher exact test, or Student t-test. The odds ratio and 95% CI were calculated for those with statistical significance. Stepwise multiple logistic regression analysis used to determine the independent factors that may predispose an infant to HIE. RESULTS: Inappropriate antenatal care (OR 9.4; 95%CI: 2.6-35.4), post-term gestation (OR 7.4; 95%CI: 1.4-34.8), vacuum extraction (OR 5.4; 95%CI: 1.1-26.8), male (OR 4.8; 95%CI: 1.3-19.1), prolapsed cord (p = 0.01) and 1 and 5-minute Apgar scores, (p < 0.0001) were significant risk factors for HIE. However, by multiple regression analysis, only a 5-minute Apgar score was significantly associated with HIE (p = 0.001). CONCLUSION: Sophisticated or expensive equipment is not necessary for the treatment of HIE patient. HIE depends mainly on adequate and effective supportive strategy. The delivery of high risk pregnancies, under obstetric facilities and with appropriate intervention and with good neonatal resuscitation, may prevent the perinatal asphyxia and thereby minimize the occurring of HIE.

Tecchnical standard for vertical delivery assistance with intercultural adaptation

The purpose of this regulation is to standardize the medical assistance on vertical delivery according to international criteria and national experience, responding to the need of adjusting the health care services offered to women in order to increase institutional delivery and thus, reduce obstetric complications that cause maternal death

Maternal, neonatal mortality and morbidity due to obstetrical procedures

Obstetrical procedure is the intervention which is done by the obstetrician to correct the advance of delivery in order to assure a healthy mother and newborn. The obstetrician can intervene by one of the following ways: 1. External and internal version. 2. Vacuum extractor. 3. Delivery forceps. 4., Cesarean session. Bleeding is the most common complication in the delivery without procedure 55.2%.. Pretermission is the most common complication after the delivery without procedure 36%. The bleeding is the most common complication 7.4% after procedure by vacuum extractor. Asphyxia is the most common complication at newborns 8.3% after delivery by vacuum extractor. Mother's morbidity percentage after delivery by forceps is 36%. Newborns' morbidity percentage after delivery by forceps is 18%. Mother's morbidity percentage after internal version of second twin is 17.5%. Newborns' morbidity percentage after internal version of second twin is 54% and the pretermission is the most common complication. Mothers' morbidity percentage after cesarean session is 17.4% and the bleeding is the most common complication. Newborns' morbidity percentage after cesarean session is 19.2% and the pretermission is the most common complication. By this study we conclude that delivery without procedure is the least morbidity for mothers and the forceps is the most morbidity for them, and the cesarean session is the most common reason for bleeding, and the internal version of second twin is the most morbidity and mortality for newborns. Therefore, obstetrician has to adhere the conditions of procedure and choose the right indication due to decrees the morbidity of mothers and newborns

[Risk factors associated with forth-degree laceration during vaginal delivery]

To identify the risk factors of fourth-degree laceration during vaginal delivery. This is a retrospective, case control study. We reviewed 131802 records of vaginal deliveries within 14 years period from 1990 to 2004 in two obstetric center. Cases were 93 vaginal deliveries with fourth-degree laceration and 7 cases were delivered at home, control subjects were 200 vaginal deliveries without third- or fourth-degree lacerations and were identified with the use of random selection. We studied the effects of: maternal age, nationality, parity, gestational age, hour of delivery, birth attendants, episiotomy use and duration of second stage of labor, use of oxytocin, use of forceps or vaccum, Infant birth weight, presentation and postion of fetus, previous severe perineal injury, maternal medical illness and place of delivery. We found 93 cases [%0.07] of documented fourth-degree laceration in 131802 deliveries This study identified several factors associated with fourth-degree laceration. Median episiotomy should be avoided. Nulliparity, fetal macrosomia and OP position are significant risk factors that require caution by birth attendants during delivery

Manometric and ultrasonographic assessment of anal sphincter function following forceps or vacuum assisted vaginal delivery

To compare differences in anal sphincter function following vacuum or forceps assisted vaginal delivery. Prospective, r and omized controlled trial. Al-Azhar University Hospitals in Damietta and Cairo.One hundred and thirty primiparous women were recruited antenatally and if an instrumental delivery was indicated, were r and omized to either a vacuum or low-cavity, non-rotational forceps assisted delivery. Follow-up consisted of a symptom questionnaire, anal manometry, and endoanal ultrasonography. Faecal continence scores, anal manometry and endoanal ultrasonography. Sixty-one women delivered with forceps assistance [42 for failure to progress in the second stage] and 69 with vacuum assistance [50 for failure to progress]; 16/69 vacuum deliveries proceeded to a forceps assisted delivery [23%]. There were no statistical differences in the antecedent antenatal factors between the two groups. A third degree perineal tear followed 7 [11%] forceps and 3 [4%] vacuum deliveries. Based on intention-to-treat analysis, 32 [52%] women complained of altered faecal continence after forceps delivery compared with 21 [30%] following vacuum delivery three months postpartum. Endoanal ultrasonography was reported as abnormal following 34 [56%] forceps deliveries and 34 [49%] vacuum deliveries. After exclusion of 'failed vacuum', median anal canal resting pressure was significantly lower following forceps delivery compared with vacuum delivery alone [p<0.001]. There were no significant differences in degree of ultrasound abnormality between the two groups. Symptoms of altered faecal continence are significantly more common following forceps assisted vaginal delivery. Based on continence outcome, when circumstances allow, vacuum should be the instrument of first choice in assisted delivery

Utilización de vacuum extractor de copa blanda en la atención de partos vaginales / Vacuum extractor with a soft cup is used in vaginal birth deliveries

En Chile, el parto vaginal instrumentalizado está reducido al uso de fórceps y espátulas de Thierry. La tendencia mundial está dirigida al uso de vacuum extractor de copa blanda. El vacuum extractor presenta múltiples ventajas en comparación con el fórceps, tales como requerimientos analgésicos menores, técnica de fácil aprendizaje y menor incidencia de traumatismo neonatal. Presentamos nuestra experiencia con el uso de vacuum extractor de copa blanda, en casos de expulsivo detenido y sufrimiento fetal, como alternativa al fórceps. Se utilizó el vacuum en 3 pacientes, sin traumatismo materno y neonatal.