It may be necessary to use certain medical equipment to assist child birth. Forceps and vacuum extraction devices both allow the physician to gain hold of the infant’s head. Through the mild pulling, the physician can help guide the infant through the birth canal.
Since the bones that comprise the skull of an infant have yet to fully fuse together, the skull is very soft for the first several months. The scalp is also not fully attached to the skull, which can increase the risk for injury and bruising. The sensitive scalp area increases the risk of injury to the infant if forceps or vacuum extraction is used to assist during the delivery.
What is Vacuum Extraction?
A vacuum extractor (sometimes called a ventouse), uses suction by attaching a plastic or metal cup connected to a tube and suction device on the baby’s head to assist in delivery by gently pulling during a mother’s contractions. This device is rarely used if the mother is less than 34 weeks along as the baby’s head is too soft. In recent years this form of extraction assistance has replaced the forceps in a variety of scenarios.
Risks Associated with Vacuum Extraction
Both a metal and a plastic cup can be employed when utilizing a vacuum extraction device. While the metal cup method is more dependable and less likely to slip, it does pose an increased risk of damage to the scalp. The soft cup vacuum extraction method is easier on both mother and infant, but poses a detachment risk. If not carefully used during delivery, bruising and injury to the scalp of the infant can occur when a physician uses vacuum extraction. Injury can also occur to the mother when vacuum extraction is not properly used.
The risk of subgaleal hemorrhage typically increases when vacuum extraction is used. This condition occurs when the area between the scalp and skull begins to bleed and swelling occurs as a result. If this condition is not treated in a timely manner anemia, shock and seizures may develop, sometimes resulting in death.
Vacuum extraction can also pose a risk to injuring the eyes of an infant. Blood or a red ring surrounding the eyes may occur; however, this is usually mild and will gradually fade. Permanent vision problems can result in more serious cases.
Using Equipment to Hasten Child Birth
There is debate among the medical community over when and how often the use of forceps or vacuum extraction should occur, and if these devices should be used in succession of one another. An article in the American Family Physician states, “There is growing evidence that newborns who experience a failed vacuum delivery followed by a attempted forceps delivery…have significantly more scalp and intracranial injuries, as well as increased morbidity and mortality.” The article also notes that these methods used in succession of one another and then followed by a caesarean delivery are likely to result in the same types of injuries and trauma.
A 2010 article in Obstetrics and Gynecology also addressed this issue, discouraging the use of these two methods in the same delivery; suggesting that following a failed vacuum extraction the physician should proceed directly to a cesarean delivery. Both periodicals have noted a positive correlation between combining these methods during the second stage of delivery and the “likelihood of death or intracranial injury.”