The method of vacuum extraction of the fetus is used when it is necessary to finish the labor quickly, and the caesarean section is undesirable or contraindicated and there are no conditions for applying forceps.
The vacuum extractor consists of a vacuum apparatus (it creates a negative pressure) and cups placed on the head of the fetus. Principle of operation - the formation of a vacuum pressure between the inner surface of the calyx and the head of the fetus. In this case, there is a cohesive force that allows you to make the traction necessary to extract the fetus.
Indications for vacuum extraction of the fetus:
- Prolonged weakness of the ancestral forces;
- The onset of fetal hypoxia;
- Loss of umbilical cord (after its correction)
- Partial exfoliation of the placenta;
- Bleeding from the marginal sinus of the placenta. Contraindications are the following conditions:
- Extension of the fetus;
- Premature birth in a period less than 35 weeks of pregnancy;
- Mismatch between the size of the head of the fetus and the pelvis of a woman;
- Diseases in which undesirable attempts (heart defects, severe forms of hesychosis, etc.)
- Dropsy of the fetal head;
- Anomalies inserted heads;
- Premature detachment of the placenta. Conditions:
- A living fruit;
- Absence of a fetal bladder;
- Full disclosure of the cervix;
- Correspondence of the size of the fetal head to the woman's pelvis;
- Occipital presentation of the fetus.
Operation technique. The cup is placed on the inner surface of the fingers of the right hand, open the entrance to the vagina with the fingers of the left hand. The cup is injected with a lateral surface in a straight size, turned into a transverse one and the aperture is leaned against the head of the fetus. Spring is the best place (here the skin covers closely to the periosteum). Create a negative pressure of 500-550 mm Hg. Control the correct application of the cup to the head (you need to exclude the possibility of splitting the walls of the vagina).
Tractions are performed synchronously with tensions along the axis perpendicular to the plane of the cup opening. The traction force should not exceed 10-15 kg (the strength of the hand of the obstetrician bent in the elbow joint).
Vacuum extractor is used rarely because of the negative influence of this intervention on the subsequent neuro-psychological development of the child.