Preventing maternal and neonatal harm during vacuum-assisted vaginal delivery.

When women in the second stage of labor fail to progress to a spontaneous delivery, vacuum extractors have been used to successfully aid delivery. Data from the U.S. Department of Health and Human Services’ National Center for Health Statistics revealed that vacuum-assisted deliveries accounted for approximately 5% of all deliveries in 2004, based on a seven-state sample of the expanded health data on birth certificates. Additionally, the use of vacuum extraction devices has increased over the last 10 years, while the use of forceps has decreased. Like other operative procedures, vacuum-assisted vaginal delivery has known risk factors and complications. The Pennsylvania Patient Safety Authority received 367 reports of problems involving vacuum-assisted delivery from July 2004 through April 2009. Of these reports, 64 (17%) documented maternal injury and 221 (60%) documented neonatal injury. To maximize the success of vacuum extraction procedures and to minimize complications, clinicians must understand both indications and contraindications for this procedure. Performing a thorough preoperative maternal and fetal assessment, technical proficiency with the vacuum device, setting goals, maintaining situational awareness, and concluding the delivery with a targeted postoperative assessment of both the mother and neonate are all important patient safety concepts associated with vacuum-assisted vaginal delivery procedures. (Pa Patient Saf Advis 2009 Dec 16;6[Suppl 1]:7-17.) Preventing Maternal and Neonatal Harm during Vacuum-Assisted Vaginal Delivery