Birth progression and traction forces developed under vacuum extraction after slow or rapid application of suction

Svenningsen, Leif

doi:10.1016/0028-2243(87)90044-x

Cited by 21 publications

(17 citation statements)

References 11 publications

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“…Hence, even the cup slipping once might be associated with injury. The rate of development of vacuum was not found to be associated with increased neonatal complications (34). Benaron suggested that the risk of bleeding after vacuum extraction is increased in primiparous women, severe dystocia, malposition of the fetal head, and multiple, forceful, or prolonged use of the vacuum suction (40).…”

Section: Duration Of Vacuum Extraction and Cup Placementmentioning

confidence: 98%

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Neonatal Subgaleal Hemorrhage and Its Relationship to Delivery by Vacuum Extraction

Uchil¹,

Arulkumaran²

2003

Obstetrical & Gynecological Survey

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Subgaleal hemorrhage is a rare condition of the neonate often associated with instrumental delivery. It is a potentially fatal condition that is often underreported and underdiagnosed. The vacuum extractor is being advocated as the instrument of first choice for assisted vaginal delivery, but appears to be associated with an increased incidence of subgaleal hemorrhage. It is widely believed that the vacuum cup will dislodge before causing serious fetal trauma. Because of the ease of application, vacuum extractors could be used potentially in circumstances in which forceps would not be attempted, allowing an operator of average experience to perform rotational deliveries. The worrisome increase in the incidence of subgaleal hemorrhage associated with vacuum extraction leads to the issuance of warnings from governmental authorities in Canada and the United States. This review discusses the anatomy of this lesion, etiology, clinical presentation, management, and possible prevention.

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Section: Duration Of Vacuum Extraction and Cup Placementmentioning

confidence: 98%

“…Once an adequate level of vacuum had been achieved, high degrees of traction could be applied to the cup regardless of the rate at which the vacuum was developed. The number and nature of neonatal complications were not influenced by the method chosen (34).…”

Section: Traction Forcesmentioning

confidence: 99%

Neonatal Subgaleal Hemorrhage and Its Relationship to Delivery by Vacuum Extraction

Uchil¹,

Arulkumaran²

2003

Obstetrical & Gynecological Survey

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“…The first report in 1987 by Svenningsen 16 compared two Figure 2. Difference of success rate after first application (%) with rapid negative pressure method versus stepwise negative pressure method.…”

Section: Discussionmentioning

confidence: 99%

“…15 More recently, there was a report indicating that there is no significant difference in the traction force developed between the stepwise and the rapid application of the vacuum. 16 As an adequate chignon usually forms within 1-2 minutes of creating negative pressure, traction may be commenced after 1-2 minutes without compromising the success rate and safety of the procedure. 15,17,18 However, in some countries, most obstetricians still use the stepwise negative pressure method, with the belief that this prevents cup detachment.…”

Section: Introductionmentioning

confidence: 99%

Rapid versus stepwise application of negative pressure in vacuum extraction-assisted vaginal delivery: a multicentre randomised controlled non-inferiority trial

Suwannachat

Laopaiboon

Tonmat

et al. 2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

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Objective To evaluate whether the application of rapid negative pressure for vacuum-assisted delivery is as effective and safe as the stepwise method.Design Randomised controlled trial.Setting Six centres, including university, secondary and tertiary hospitals, in Thailand.Sample In total, 662 women were randomised to rapid and stepwise groups, with 331 women in each group.Methods Vacuum extraction was performed by applying a metal cup (Malmstrom) connected to an electric pump to the fetal head. The stepwise method consisted of four incremental steps of 0.2 kg/cm 2 every 2 minutes to obtain a final negative pressure of 0.8 kg/cm 2 . In the rapid method the negative pressure of 0.8 kg/cm 2 was applied in one step in <2 minutes.Main outcome measures Success rate of vacuum extraction, vacuum cup detachment rate, duration of vacuum extraction, and maternal and neonatal complications.Results There were no significant differences in detachment rates (RD 0.3%, 95% CI )3.1 to 2.4). The overall success rates were identical, at 98.2%. There were significant reductions in the time between applying the vacuum cup and attaining maximum negative pressure (MD )4.6 minutes; 95% CI )4.4 to )4.8 minutes), and in the time between applying the cup and delivery (MD )4.4 minutes; 95% CI )4.8 to )4.0 minutes). There was a significantly higher rate of perineal suture in the rapid method group (RD 4.5%; 95% CI 1.1-8.2). There were no significant differences in maternal and fetal morbidities.Conclusions Rapid negative pressure vacuum extraction could be performed as effectively and safely as the stepwise method, in a shorter period of time.Keywords Negative pressure, rapid, stepwise, vacuum extraction.Please cite this paper as: Suwannachat B, Laopaiboon M, Tonmat S, Siriwachirachai T, Teerapong S, Winiyakul N, Thinkhamrop J, Lumbiganon P. Rapid versus stepwise application of negative pressure in vacuum extraction-assisted vaginal delivery: a multicentre randomised controlled non-inferiority trial.

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“…In most studies no comparison of the two methods of application of negative pressure has been described to support these statements. Svenningsen compared a one‐step with a stepwise application of vacuum in ventouse extraction procedures 12 . He concluded that the effectiveness of the rapid method of application suction was equal to the effectiveness of the slow method and that maternal and neonatal morbidity were not influenced by the method of building up negative pressure.…”

Section: Introductionmentioning

confidence: 99%

Stepwise compared with rapid application of vacuum in ventouse extraction procedures

Lim¹,

Holm²,

Schuitemaker³

et al. 1997

BJOG

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Birth progression and traction forces developed under vacuum extraction after slow or rapid application of suction

Cited by 21 publications

References 11 publications

Neonatal Subgaleal Hemorrhage and Its Relationship to Delivery by Vacuum Extraction

Neonatal Subgaleal Hemorrhage and Its Relationship to Delivery by Vacuum Extraction

Rapid versus stepwise application of negative pressure in vacuum extraction-assisted vaginal delivery: a multicentre randomised controlled non-inferiority trial

Stepwise compared with rapid application of vacuum in ventouse extraction procedures

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