Ventouse
Encyclopedia
Ventouse is a vacuum
Vacuum
In everyday usage, vacuum is a volume of space that is essentially empty of matter, such that its gaseous pressure is much less than atmospheric pressure. The word comes from the Latin term for "empty". A perfect vacuum would be one with no particles in it at all, which is impossible to achieve in...

 device used to assist the delivery of a baby when the second stage of labour
Childbirth
Childbirth is the culmination of a human pregnancy or gestation period with the birth of one or more newborn infants from a woman's uterus...

 has not progressed adequately. It is an alternative to a forceps delivery
Forceps in childbirth
Forceps are a surgical instrument that resembles a pair of tongs and can be used in surgery for grabbing, maneuvering, or removing various things within or from the body...

 and caesarean section
Caesarean section
A Caesarean section, is a surgical procedure in which one or more incisions are made through a mother's abdomen and uterus to deliver one or more babies, or, rarely, to remove a dead fetus...

. It cannot be used when the baby is in the breech position
Breech birth
A breech birth is the birth of a baby from a breech presentation. In the breech presentation the baby enters the birth canal with the buttocks or feet first as opposed to the normal head first presentation....

 or for premature birth
Premature birth
In humans preterm birth refers to the birth of a baby of less than 37 weeks gestational age. The cause for preterm birth is in many situations elusive and unknown; many factors appear to be associated with the development of preterm birth, making the reduction of preterm birth a challenging...

s. This technique is also called vacuum-assisted vaginal delivery or vacuum extraction (VE). The use of VE is generally very safe, but it can occasionally have negative effects on either the mother and the child.

Technique

The woman is placed in the lithotomy position
Lithotomy position
The lithotomy position is a medical term referring to a common position for surgical procedures and medical examinations involving the pelvis and lower abdomen, as well as a common position for childbirth in Western nations...

 and assists throughout the process by pushing. A suction
Suction
Suction is the flow of a fluid into a partial vacuum, or region of low pressure. The pressure gradient between this region and the ambient pressure will propel matter toward the low pressure area. Suction is popularly thought of as an attractive effect, which is incorrect since vacuums do not...

 cup is placed onto the head of the baby and the suction draws the skin from the scalp into the cup. Correct placement of the cup directly over the flexion point
Flexion point
In obstetrics, the term flexion point refers to a spot on the fetal head on which the cup of a ventouse should to be placed for extraction of the child to be most effective....

, about 3 cm anterior from the occipital (posterior) fontanelle
Fontanelle
A fontanelle is an anatomical feature on an infant's skull.-Anatomy:Fontanelles are soft spots on a baby's head which, during birth, enable the bony plates of the skull to flex, allowing the child's head to pass through the birth canal. The ossification of the bones of the skull causes the...

, is critical to the success of a VE. Ventouse devices have handles to allow for traction. When the baby's head is delivered, the device is detached, allowing the accoucheur and the mother to complete the delivery of the baby.

For proper use of the ventouse, the maternal cervix has to be fully dilated, the head engaged in the birth canal, and the head position known. If the ventouse attempt fails, it may be necessary to deliver the infant by forceps
Forceps
Forceps or forcipes are a handheld, hinged instrument used for grasping and holding objects. Forceps are used when fingers are too large to grasp small objects or when many objects need to be held at one time while the hands are used to perform a task. The term 'forceps' is used almost exclusively...

 or caesarean section
Caesarean section
A Caesarean section, is a surgical procedure in which one or more incisions are made through a mother's abdomen and uterus to deliver one or more babies, or, rarely, to remove a dead fetus...

.

Indications for use of vacuum

There are several indications to use a ventouse to aid delivery:
  • Maternal exhaustion
  • Prolonged second stage of labor
  • Foetal distress in the second stage of labor, generally indicated by changes in the foetal heart-rate (usually measured on a CTG
    Cardiotocography
    In medicine , cardiotocography is a technical means of recording the fetal heartbeat and the uterine contractions during pregnancy, typically in the third trimester...

    )
  • Maternal illness where prolonged "bearing down" or pushing efforts would be risky (e.g. cardiac conditions, blood pressure, aneurysm, glaucoma). If these conditions are known about before the birth, or are severe, then an elective caesarean section
    Caesarean section
    A Caesarean section, is a surgical procedure in which one or more incisions are made through a mother's abdomen and uterus to deliver one or more babies, or, rarely, to remove a dead fetus...

     may be performed.

Positive aspects

  • An episiotomy
    Episiotomy
    An episiotomy , also known as perineotomy, is a surgically planned incision on the perineum and the posterior vaginal wall during second stage of labor. The incision, which can be midline or at an angle from the posterior end of the vulva, is performed under local anaesthetic , and is sutured...

     may not be required.
  • The mother still takes an active role in the birth.
  • No special anesthesia
    Anesthesia
    Anesthesia, or anaesthesia , traditionally meant the condition of having sensation blocked or temporarily taken away...

     is required.
  • The force applied to the baby can be less than that of a forceps delivery, and leaves no marks on the face.
  • There is less potential for maternal trauma compared to forceps and caesarean section.

Negative aspects

  • The baby will be left with a temporary lump on its head, known as a chignon.
  • There is a possibility of cephalohematoma formation, or subgaleal hemorrhage.

External links

The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
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