
Written by Editorial Team
Have you heard about vacuum-assisted birth? As the labor progresses, near the end of the pushing stage, sometimes mother and baby require additional support. This is called assisted birth.
As the mother pushes, the doctor or nurse who attends to the delivery will carefully help the baby’s head out through the birth canal. Approximately one in eight women have to undergo assisted birth. This can be either vacuum-assisted or forceps-assisted.
The vacuum-assisted birth is a procedure in which the doctor uses Ventouse (vacuum extractor) to help the baby out of the birth canal. The doctor attaches this instrument to the baby’s head through suction. This instrument is Ventouse. A cup that is usually of soft plastic or metal and connects by a tube to the suction device.
The cup firmly fits the baby’s head. As the mother pushes through the next contraction, the doctor will gently apply a small amount of suction to the baby’s head and assist the baby’s head through the birth canal. Vacuum-assisted delivery is not performed in case of preterm delivery specifically if the delivery happens before the 34th week, as the baby’s head will be too soft during that time.
The doctors choose vacuum-assisted delivery if:
The team plans a vacuum-assisted birth only if the hospital has the facility to carry a C-section. This is because if the vacuum assistance fails, C-section might be the only option.
There are different types of ventouse that vary in size and material which is used for the ‘cup’ portion of the instrument. The selection of the size and type of the cup depends on several factors like:
The most common type of vacuum extractors are:
As the name implies, the cup is metal. It also has the shape of a mushroom. The diameter of this cup varies from 40 to 60 mm. The doctor choose metal cup when the baby’s head is higher in the birth canal. This type of vacuum extractor helps with more difficult delivery like brow presentation or in occiput posterior (OP) position (back of baby’s head facing mother’s back) or in case of a distressed baby.
Also, the doctor may choose the metal cup if the full dilation (7cm dilation is enough) fails to happen. The benefit of using this type of ventouse is its higher success rate over the semi-rigid cup and a soft cup. The disadvantage is that it increases the chances of fetal scalp injury
This type of suction cup is of flexible plastic. This is softer than the metal cup and more rigid than the soft cup. Doctors opt for a semi-rigid cup in similar conditions as a metal cup. The benefit of using this cup is that it lowers the chances of fetal scalp injury than the metal cup. The disadvantage of this type of suction cup is that it is less successful than the metal cup.
Made of hard, but flexible, rubber or silicone. The medical team uses this cup only if the baby’s head is relatively low in the birth canal. The main disadvantage is its lower success rate. As said earlier, it can only be successful if the baby is very low and needs only little assistance to pull the baby’s head through the birth canal.
However, this cup is very difficult to correctly fit a baby’s crown if the baby is higher in the birth canal, or the baby is in an OP position
There are certain prerequisites for the possibility of vacuum-assisted birth. Some of them are:
The doctor will not choose vacuum-assisted birth:
Most of the risks associated with vacuum-assisted delivery to the mother can happen during the normal vaginal birth too. Here are some common risks comes with vacuum-assisted delivery to the mother:
This happens when the vacuum birth weakens the ligaments and muscle that holds up the pelvic organs
Unintentional urine leakage can happen as a result of vacuum delivery. This can be rectified by physiotherapy
If a third or fourth-degree tear occurs during vacuum-assisted delivery, anal incontinence (involuntary defecation) can happen
Pain in the perineum after delivery is common in vacuum-assisted delivery
The baby born through vacuum-assisted birth can have both significant and minor issues. Some of the commonly found risks are:
The swelling that happens in the shape of a cone to the area where the suction cup attaches is chignon. The swelling will resolve within two to three days. Besides, it is an indication of successful vacuum delivery.
It refers to the accumulation of blood in the space under the fibrous covering of skull bone. It is a relatively harmless condition and will resolve within a couple of weeks when the baby’s body reabsorbs the blood.
This is one of the most dangerous complications of vacuum-assisted delivery. This potentially life-threatening condition happens as a result of the accumulation of blood in a relativity larger area of the skull just beneath the scalp.
A lot of blood loss can happen this way. This happens due to significant damage that occurs in the veins under the scalp. This takes place when the suction is not strong enough to pull the baby’s head and instead it pulls the scalp.
Neonatal jaundice occurs when the level of bilirubin increases as a result of the breakdown of RBC. This risk is due to its increased chances of blood vessel damage during vacuum suction. Thoughbaby’s body reabsorbs most of the blood, the breakdown of blood results in increased production of bilirubin.
As the baby’s liver (which removes bilirubin from the body) is still developing, it may not be able to deal with the increased bilirubin, and as a result, the baby suffers from neonatal jaundice.
It is a very rare condition that comes with vacuum-assisted birth. However, it can lead to harmful long-term side effects like speech loss, memory loss, etc. Depending on the part of the brain that gets affected. It is basically the hemorrhage that happens inside the skull.
Due to the pressure placed on the baby’s head, retinal hemorrhage, which is bleeding behind the eyes, can happen after vacuum-assisted birth. It usually resolves without further complications.
This happens when the collarbones and brachial plexus get stuck or are wrongly placed in the birth canal. In this case, there will be excess pressure as the vacuum pulls out the baby’s head through the birth canal.
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