Vacuum Extractor
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2021 ◽  
Vol 11 (17) ◽  
pp. 8237
Author(s):  
Yu-Hsuan Chen ◽  
Kuo-Min Su ◽  
Ming-Tzu Tsai ◽  
Chi-Kang Lin ◽  
Cheng-Chang Chang ◽  
...  

Operative delivery requires the use of a vacuum extractor; obstetricians can choose the appropriate vacuum extractor to make the delivery process smoother and safer. However, there is no biomechanical literature focused on the imposed effects of a vacuum extractor prepared with different materials and vacuum pressure on the fetal head during the process of delivery. Therefore, we first established and performed the finite element analytical model to explore the influences of vacuum extractors manufactured from different materials on the fetal head under various extractive pressures. The model of the vacuum extractor was designed as a hemispherical shape, and the material of the vacuum extractor was composed of silicone rubber and stainless steel for comparison. Four different vacuum pressures (500 cm H2O, 600 cm H2O, 700 cm H2O, and 800 cm H2O) were applied as the factors for investigation. The reaction force on the fetal head, von Mises stress of vacuum extractor, and von Mises stress on the skull of fetal head were measured and analyzed to evaluate the effects. The results revealed that subtle divergent influences of different vacuum pressures were observed, and the stainless-steel vacuum extractor induced a larger reaction force (358.04–361.37 N), accompanied with stress (13.547–13.675 MPa), on the fetal head than non-metallic or relatively softer materials. The results provide a reliable basis for selecting proper vacuum extractor during operative delivery to avoid obstetrical complications, such as scalp scratch, cephalohematoma and even intracerebral hemorrhage.


Author(s):  
Shahenda H. Basha ◽  
Doaa N. Shatat ◽  
Adel E. Elgergawy ◽  
Mohsen M. Elnamoury

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.


2021 ◽  
Author(s):  
Yu-Hsuan Chen ◽  
Kuo-Min Su ◽  
Ming-Tzu Tsai ◽  
Chi-Kung Lin ◽  
Cheng-Chang Chang ◽  
...  

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.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Perrine COSTE MAZEAU ◽  
Nedjma BOUKEFFA ◽  
Nathalie TICAUD BOILEAU ◽  
Samantha HUET ◽  
Maud TRAVERSE ◽  
...  

Abstract Background Instrumental deliveries are an unavoidable part of obstetric practice. Dedicated training is needed for each instrument. To identify when a trainee resident can be entrusted with instrumental deliveries by Suzor forceps by studying obstetric anal sphincter injuries. Methods A French retrospective observational study of obstetric anal sphincter injuries due to Suzor forceps deliveries performed by trainee residents was conducted from November 2008 to November 2016 at Limoges University Hospital. Perineal lesion risk factors were studied. Sequential use of a vacuum extractor and then forceps was also analyzed. Results Twenty-one residents performed 1530 instrumental deliveries, which included 1164 (76.1%) using forceps and 89 (5.8%) with sequential use of a vacuum extractor and then forceps. Third and fourth degree perineal tears were diagnosed in 82 patients (6.5%). Residents caused fewer obstetric anal sphincter injuries after 23.82 (+/− 0.8) deliveries by forceps (p = 0.0041), or after 2.36 (+/− 0.7) semesters of obstetrical experience (p = 0.0007). No obese patient (body mass index> 30) presented obstetric anal sphincter injuries (p = 0.0013). There were significantly fewer obstetric anal sphincter injuries after performance of episiotomy (p <  0.0001), and more lesions in the case of the occipito-sacral position (p = 0.028). Analysis of sequential instrumentation did not find any additional associated risk. Conclusion Training in the use of Suzor forceps requires extended mentoring in order to reduce obstetric anal sphincter injuries. A stable level of competence was found after the execution of at least 24 forceps deliveries or after 3 semesters (18 months) of obstetrical experience.


2020 ◽  
Vol 48 (7) ◽  
pp. 694-699
Author(s):  
Marcos Javier Cuerva ◽  
Jose Ángel Espinosa ◽  
Silvia Barras ◽  
Silvia Gonzalez-Cerron ◽  
Faride Ojeda ◽  
...  

AbstractObjectivesThe purpose of this study is to compare the vacuum extractor cup application technique described by Bird vs. the technique described by Vacca on a simulation model.MethodsSix obstetricians participated in the study. Each obstetrician performed eight vacuum assisted deliveries using the Bird technique and eight vacuum assisted deliveries using the Vacca 5-Steps technique.ResultsA total of 96 vacuum assisted deliveries were performed. The mean distance from the centre of the cup to the flexion point was 1.78±0.96 cm for the Bird technique and 1.05±0.60 cm for the Vacca technique (p<0.001). The lateral distance (over the parietal bone) was 1.16±0.69 cm for the Bird technique and 0.66±0.52 cm for the Vacca technique (p<0.001). The vertical distance (towards the frontal or occipital bone) was 1.12±1.02 cm for the Bird technique and 0.67±0.55 cm for the Vacca technique (p=0.009). In occipito anterior positions, there were no significant differences between both techniques.ConclusionsThe Vacca technique was better in transverse and posterior positions.


Author(s):  
Diana Buglea
Keyword(s):  

Le roman Vacuum (2003) de Christian Mistral se fait l’écho à notre époque de deux obsessions majeures : celle de la technologie et celle de se dire. Nous allons montrer que dans ce texte, qui a pris d’abord la forme d’un journal (éponyme) en ligne, l’utilisation du dispositif informatique (outil de communication privilégié en ce début de nouveau millénaire) et la manipulation de la matière du journal (support de l’œuvre à venir) sont le mobile d’un régime émotionnel chez le narrateur – un écrivain abandonné par sa muse qui raconte et commente son quotidien alors que son livre en chantier tarde à se concrétiser. Dans l’attente des mots justes et dociles, cet exutoire, vacuum extractor est salutaire : convié dans son « Bunker » où l’ordinateur, Memory Babe, a pris la place d’une vieille Underwood, le lecteur apprend la complicité de la nouvelle machine, l’épuisement de cette magie et le changement de destin du livre qui peine à mûrir.


2018 ◽  
Vol 46 (3) ◽  
pp. 279-286 ◽  
Author(s):  
Nicola Perone

Abstract Objective: To describe an innovative electronically-controlled vacuum extractor (VE) in detail and to illustrate its performance characteristics, as observed in a laboratory study. Design: Thirty simulated, vacuum-assisted deliveries. Main outcome measure(s): (1) The ability to measure in real-time of the pull applied and to sound an alert, when the traction approaches the negative pressure under the cup, to prevent its detachment. (2) The recording and printing of a graphic representation of the pull applied (vacuum delivery graph). (3) The emission of a warning signal when the 15-min time limit of continuous cup application on the fetal scalp, is reached. Results: No cup detachment occurred in any of the 15 vacuum-assisted deliveries, in which traction was kept below the adhesive force of the cup [44 lb (20 kg)], except in three cases, due to loss of negative pressure. In the remaining 15 tests, in which traction was greater than the adhesive force of the cup, “pull-offs” inevitably occurred. Furthermore, upon reaching the 15-min time limit of continuous cup application on the fetal cephalic model, a warning signal was emitted, as programmed. Conclusions We demonstrated that the electronically-controlled VE, with its distinctive pull-sensing handle, performs suitably for its intended purposes. The ability of the modernized device to decrease the incidence of cup detachment, secondary to the inadvertent application of excessive traction, may result in considerable safety, medico-legal and didactic advantages.


2015 ◽  
Vol 30 (2) ◽  
pp. 24-29
Author(s):  
Ada Alzamora Valencia ◽  
Alma Pastor Barraquino ◽  
Miguel Oliveros Donohue ◽  
César Livia Becerra
Keyword(s):  

Se estudió 618 bebés macrosómicos de una población de 8,880 recién nacidos vivos (6.9%). Para los propósitos de nuestro análisis se consideró 500 casos, encontrándose la asociación de ciertos factores maternos y fetales con macrosomía, como paridad y edad (43%), edad gestacional de 39 semanas o más (90%), diabetes materna (1.9%) sexo masculino (65%). La aplicación del vacuum extractor fue el doble con respecto a la población general (4 .6%: 2.1 %). La morbilidad del macrosómico fue el doble de la del recién nacido de peso normal (28%: 14%). La incidencia de asfixia, aspiración de meconio y trauma al nacimiento se incrementó en relación al peso. La tasa de mortalidad neonatal en los macrosómicos fue de 8%, la causa de muerte relacionada en especial al tamaño fetal. Para mejorar el pronóstico del infante macrosómico, se debe establecer un manejo combinado pediátrico-obstétrico orientado a identificar la población en riesgo y la detección antenatal de la macrosomía, en un intento de disminuir la morbilidad asociada al evento del parto. 


2015 ◽  
Vol 35 (8) ◽  
pp. 33-35
Author(s):  
Jorge Vidal Amat y León

El presente trabajo corresponde a la experiencia en el manejo del MITYVAC VACUUM DELIVERY SYSTEM y el nuevo CMI VACUUM D.S. presentada en un hospital materno infantil de Lima, Perú, distrito del Rímac y pacientes privados. Ampliando nuestra experiencia a una publicación del año 87. La significación tan importante que ha tenido el uso en el Perú de este instrumento ha permitido un importante apoyo en la dura y riesgosa jornada de la vida, que es el nacimiento. El MITYVAC se compone de un vacuum extractor, instrumento sencillo cuya difusión es cada vez mayor en hospitales de los Estados Unidos de Norte América, lo mismo que en Latinoamérica. Particularmente en el Perú su utilización se presenta desde el año 1986 desplazando al FORCEPS y al VACUUM EXTRACTOR DE MALMSTRONG reduciendo de esta manera los riesgos al momento del parto. La creación del MITYVAC VACUUM DELIVERY SYSTEM obedece a la COLUMBIA MEDICAL & SURGICAL, de esta manera miles de especialistas están poniendo en práctica una de las más importantes logros en cuanto a instrumental gineco obstetra se refiere, de los últimos años. Consideramos basados en la experiencia ilustrativa de su manejo, que con el MITYVAC VACUUM DELIVERY SYSTEM se facilita y se otorga máxima seguridad para la madre y el infante en aquellos partos que pudiese presentar dificultades. Lo consideramos: Simple, seguro, muy efectivo y de uso inmediato estando preparado estérilmente con equipos descartables. Su uso es responsabilidad del especialista basado en su evaluación y experiencia como factor decisivo para indicar el momento preciso para su aplicación. El MITYVAC está preparado para aumentar la potencia expulsiva de la madre y facilitar la natural rotación de la cabeza fetal, acortándose el periodo expulsivo durante el parto vaginal; pudiéndose también usar en operaciones cesáreas.


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