Use of the vacuum extractor for deflvery of the fetal head at cesarean section

Background: For multifactorial reasons, the rate of cesarean deliveries increased clearly over a decade; decreased in vaginal births after cesarean (VBAC), multiple gestation, maternal obesity, pre-term labor, gestational diabetes or hypertension, increased number of high-risk expectant mothers and the obstetrical medico-legal environment. Delivering the fetal head at cesarean section can also be a lengthy operation and can result in maternal or fetal Complications. The vacuum extractor allows for the application of traction on the fetal head. In this study we aim to compare the safety (for mother and infant) and efficacy of delivery of the fetal head in cesarean section using vacuum extractor with the manual extraction. Methods: This study was conducted on 60 pregnant women undergoing cesarean section. All patients were between 37 and 42 weeks of pregnancy with signs of healthy fetus and were divided into 2 groups; Group I- 30 patients subjected to vacuum extraction at the cesarean section, Group II- 30 patients subjected to the conventional cesarean method. The result: The BMI of women in group I was 27.90 ± 0.96 and in group II was 28.0 ± 0.98. The gestational age of the babies in Group I and II were 39.0 ± 1.02 and 39.0 ± 0.98 weeks. U-D interval for Group I and Group II were 48.40 ± 17.63 and 73.87 ± 16.76 days respectively. The estimated blood loss in group I and group II were 478.0 ± 59.62 and 464.7 ± 52.57 respectively. The birth weight of the babies delivered in Group I and Group II were 4253.33 ± 118.72 and 4246.67 ± 135.58 KG respectively. The five minutes Apgar score for Group I and Group II were 8.50 ± 0.68 and 8.57 ± 0.57. Conclusion: The use of the vacuum extractor at cesarean section may be a safe and effective method to facilitate delivery of the large fetal head and cesarean section delivery can be simplified by this technique.

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Hand Forceps vs. Conventional One-hand Technique for Fetal Head Extraction During Cesarean Section

Case Medical Research ◽

10.31525/ct1-nct04159857 ◽

2019 ◽

Author(s):

Keyword(s):

Cesarean Section ◽

Fetal Head

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Disengagement of the Deeply Engaged Fetal Head during Cesarean Section Conventional Method versus Reverse Breech Extraction- Review of Literature

Clinics in Mother and Child Health ◽

10.4172/2090-7214.1000239 ◽

2016 ◽

Vol 13 (2) ◽

Author(s):

Seema Chopra

Keyword(s):

Cesarean Section ◽

Conventional Method ◽

Review Of Literature ◽

Fetal Head ◽

Breech Extraction

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Difficult delivery of the impacted fetal head during cesarean section: intraoperative disengagement dystocia

Journal of Perinatal Medicine ◽

10.1515/jpm.2004.152 ◽

2004 ◽

Vol 32 (6) ◽

Cited By ~ 29

Author(s):

Isaac Blickstein

Keyword(s):

Cesarean Section ◽

Fetal Head

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Comparative study of vectis versus manual method for extraction of fetal head during lower segment cesarean section

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20164630 ◽

2016 ◽

Vol 6 (1) ◽

pp. 34

Author(s):

Priyanka HK ◽

Madhavi Yeddala ◽

Vimala KR ◽

Shailaja N. ◽

Bhat BS ◽

...

Keyword(s):

Cesarean Section ◽

Neonatal Outcomes ◽

P Value ◽

Lower Segment ◽

Fetal Head ◽

Abdominal Incision ◽

Manual Method ◽

Lower Segment Cesarean Section ◽

Manual Extraction ◽

Fundal Pressure

Background: Delivery of fetal head through uterine incision is often the major technical problem during low transverse cesarean section when the presenting part is unengaged. Techniques to deliver head under special circumstances are traumatic to both mother and fetus. This study aims to establish the role of vectis in extraction of fetal head during lower segment cesarean section (LSCS) and to assess associated difficulties or untoward effects of use of vectis over manual method.Methods: The study was undertaken in PESIMSR, Kuppam, Andhra Pradesh over two years. Vectis was used in extraction of fetal head in LSCS in 100 cases of full term pregnancy and maternal and neonatal outcomes were compared with 100 cases of manual extraction.Results: Incision-delivery time interval was similar in both vectis and manual extraction method (p value of 0.390). Vectis group did not require any fundal pressure for extraction of head where as 100% of women in manual extraction group required fundal pressure (p value: <0.001) which is statistically significant. The length of abdominal incision for majority of cases in vectis group was smaller and statistically significant compared to manual extraction group (p value of 0.001). Neonatal outcomes were similar in both the groups.Conclusions: As per our study, usage of vectis has shown significant advantage in reducing maternal discomfort caused due to fundal pressure and length of abdominal incision required, with negligible difference in neonatal and other maternal outcomes in comparison to manual method of extraction.

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Bimanual delivery of the fetal head at cesarean section with the fetal head in midcavity

Archives of Gynecology ◽

10.1007/bf02114726 ◽

1983 ◽

Vol 234 (1) ◽

pp. 59-60 ◽

Cited By ~ 7

Author(s):

T. H. Lippert

Keyword(s):

Cesarean Section ◽

Fetal Head

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Disengaging the deeply impacted fetal head during cesarean section

Acta Obstetricia Et Gynecologica Scandinavica ◽

10.3109/00016349.2010.487516 ◽

2010 ◽

Vol 89 (6) ◽

pp. 851-851

Author(s):

Seema Chopra ◽

Rashmi Bagga ◽

Anish Keepanasseril ◽

Vanita Jain ◽

Jaswinder Kalra ◽

...

Keyword(s):

Cesarean Section ◽

Fetal Head

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Effects of Attraction of Vacuum Extractors of Different Materials and Pressures on the Fetal Head During Delivery

10.21203/rs.3.rs-543589/v1 ◽

2021 ◽

Author(s):

Yu-Hsuan Chen ◽

Kuo-Min Su ◽

Ming-Tzu Tsai ◽

Chi-Kung Lin ◽

Cheng-Chang Chang ◽

...

Keyword(s):

Finite Element ◽

Stainless Steel ◽

Von Mises Stress ◽

Reactive Force ◽

Fetal Head ◽

Element Analysis ◽

Vacuum Extractor ◽

The Finite Element Analysis ◽

Von Mises ◽

Analysis Models

Abstract PurposeIn some cases where operative deliveries are required with vacuum extractor, and obstetricians could choose the vacuum extractor to facilitate the process smoother and safer. However, there is no related biomechanical literature about the influences of vacuum extractors fabricated from different materials and pressures of vacuum on the fetal head. Hence, we utilized the finite element method to investigate the influences of vacuum extractors manufactured from different materials on the fetal head under various extractive pressures.MethodsFirst, the finite element analysis models of vacuum extractor and fetal head were established. The vacuum extractor model was designed as a hemispherical shape and we compared silicone rubber and stainless steel for the materials of vacuum extractor. Subsequently, four different vacuum pressures were applied as the factors for investigation—500-cm H2O, 600-cm H2O, 700-cm H2O, and 800-cm H2O. Finally, we observed and analyzed the reactive force on the fetal head, von Mises stress of vacuum extractor, and von Mises stress on the skull of fetal head to evaluate the influences of vacuum extractors of different materials under different pressures. ResultsThe results demonstrated that different vacuum pressures had only a slight difference of influences on the fetal head. The use of stainless-steel vacuum extractors caused a relatively larger reactive force (358.04–361.37 N) and stress (13.547–13.675 MPa) on the fetal head. ConclusionsNon-metallic or relatively softer materials could be selected when using a vacuum extractor for operative delivery to avoid complications such as scalp scratch, and even cephalohematoma and intracerebral hemorrhage.

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