USMLE Step 2 CK Lecture Notes 2019: Obstetrics/Gynecology (Kaplan Test Prep)

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Prerequisites for vacuum extractor use include:


Complications can include vaginal lacerations from entrapment of vaginal
mucosa between the suction cup and fetal head (maternal), neonatal
cephalohematoma and scalp lacerations (common), and life-threatening
complications of subgaleal hematoma or intracranial hemorrhage
(uncommon but associated with vacuum duration >10 min) (neonatal).


Prolonged   second  stage:  This    may be  because of  dysfunctional   labor   or
suboptimal fetal head orientation.
Nonreassuring EFM strip: The FHR monitor pattern suggests the fetus is
not tolerating labor.
Avoid maternal pushing: These include various conditions in which pushing
efforts may be hazardous to the parturient, e.g., cardiac, pulmonary, or
neurologic disorders.

Clinically  adequate    pelvic  dimension
Experienced operator
Full cervical dilation
Engaged fetal head
Gestational age ≥34 weeks
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