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Vacuum Assisted Vaginal Delivery

Vacuum delivery may be indicated for various reasons related either to mother or the baby. This procedure involves utilization of vacuum extractor to avoid cesarean section or injury to the baby.

Vacuum-assisted vaginal delivery is associated to number of risks, but when the vacuum is properly used benefits outweigh the risks in both mother and baby.

Risks of Vacuum Assisted DeliveryRisks of vacuum delivery range from mild cosmetic scalp alterations to life-threatening complication.

External Scalp Markings

This is the frequent result of vacuum deliveries. It involves swelling of small area of the head. This swelling gives the baby’s head appearance of cone-shaped called chignon. This will occur after the vacuum force is applied when extractor draws the fetal scalp into the cup. The chignon formation resolves within two or three days. Modern plastic or silastic vacuum cups, unlike metal cups used in the past, and less likely result in swelling of the large area.

About 10% of vacuum assisted vaginal deliveries result in abrasion of the scalp. These abrasions are usually superficial and nearly always healed without leaving a trace. Scalp injuries are frequently resulting from complicated extended procedure.

Hematoma

Hematoma is a collection of blood under the skin that is result of bleeding. There are two types of hematoma that occur due to vacuum delivery.

CephalohematomaIt is a bleeding located under fibrous covering of the skull bone and it happens in around 6% of infants born by vacuum extraction. There isn’t any particular treatment for this complication and it usually takes up to two weeks to resolve.

Subgaleal Hematoma

This is a more serious form of bleeding and the most feared complication of vacuum extraction. Subgaleal hematoma represents blood accumulated just under the scalp. This occurs when scalp and the layer of tissue under the scalp are pulled away from the skull thus injuring the underlying veins. Fortunately, this complication rarely occurs. Subgaleal hematoma can also result from forceps deliveries. Advantage of the use of soft plastic vacuum cup is a decreased occurrence of such complication.

Neonatal Jaundice

Jaundice in infants refers to yellow skin color that occurs due to breakdown of red blood cells and the following production of bilirubin. This may often occur in a baby affected by cephalohematoma or subgaelal hematoma.

Intracranial HemorrhageIt is a very rare complication of vacuum extraction that occurs due to injury of veins and consequent bleeding around newborn’s brain.

Retinal Hemorrhage

Retinal hemorrhage represents small areas of bleeding on the back of the eyes. This is common complication that resolves spontaneously.

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