Vacuum Extraction Use in a Community Hospital Setting

The history or vacuum extraction and its use in a specific community hospital setting is reviewed. Basic principles for successful use of the extractor are cited. Two hundred twenty-eight consecutive vacuum extraction cases occurring in an 18-month period are evaluated for indications and outcome. The most common indications were fetal distress, 41.6%; malposition of the vertex, 35%; and dysfunctional labor, 14.6%. Several subjects exhibited more than one condition influencing the decision to use the extractor. Particular reference is made to the occurrence of significant trauma to the fetal scalp in 18.7% of cases. Careful choice of candidates for vacuum extraction and adherence to principles of application and traction technique are emphasized to reduce the incidence of fetal scalp trauma.