3
1) Arrest of descent where fetopelvic relaonships are considered to be inadequate,
2) Unengaged presenng part, 3) All non-vertex presentaons 4) Non-ruptured
membranes, 5) Incomplete cervical dilaon and eacement, 6) Extreme
prematurity, 7) Known fetal coagulopathies.
ACOG Technical Bullen #154 Nov. 2015: “As with forceps procedures, there should
be a willingness to abandon aempts at vacuum delivery if sasfactory progress is
not made.”
1) Gestaonal age less than 37 weeks or esmated fetal weight (EFW) less than
2500 grams, 2) Previous scalp sampling, 3) Scalp damage, 4) Failure
of eorts during prolonged period aer properly assessed placement,
5) Delivery requiring unusual amounts of tracon, 6) Suspected macrosomia.
Adverse Events
Fetal Injuries: cephalhematoma, subdural, subgaleal, intraventricular, or
parenchymal hematoma, subconjuncval, intracranial, or renal hemorrhage, nerve
injuries, subjecve jaundice, elevated bilirubin, bruises, contusions, laceraons,
fractures.
Maternal Injuries: So ssue injuries, episiotomy extensions.
Warnings
Limit use to trained, experienced, or supervised operators. Inseron should
be performed carefully, using asepc technique. Forced inseron may result in
malfuncon, paent discomfort, or paent/fetal trauma.
