Vacuum-Assisted Delivery

Address – consent
Anaesthesia – adequate pain relief
Assistance – neonatal support
Absence – of contraindications
Bladder – empty
Cervix – fully dilated and ruptured membranes
Contractions – adequate
Determine – position, station and pelvic adequacy, consider shoulder dystocia
Equipment – inspect vacuum cup, pump, tubing and check pressure
Fontanelle – position cup just anterior to or over the posterior fontanelle, sweep finger around cup to clear maternal tissue, 100 mmHg initially
Gentle Traction – as contraction begins, increase pressure to 600 mmHg (follow manufacturer’s range), prompt mother for good expulsive effort, pull with contractions only, traction in axis of birth canal
Halt – if no progress with three traction-aided contractions, three pop-offs, >20 min (1/3rd an hour) of total application
Incision – consider episiotomy
Jaw – remove vacuum when jaw is reachable or delivery assured