68 Obstetrics and Gynecology Board Review •••
❍ The definition of midforceps is?
Station is above +2 cm but head is engaged.
❍ True or False: According to the ACOG practice bulletin, vacuum extractors are designed to limit the amount
of traction on the fetal skull because detachment can occur. Nevertheless, traction achieved with vacuum
extraction is substantial (up to 50 lb) and can result in significant fetal injury if misused.
True.
❍ The two FDA recommendations for the use of the vacuum device that rocking movements or torque should
not be applied to the device; only steady traction in the line of the birth canal should be used and clinicians
caring for the neonate should be alerted that a vacuum device has been used so that they can adequately
monitor the neonate for the signs and symptoms of device-related injuries.
True.
❍ According to the ACOG practice bulletin, the lowest rate of neonatal intracranial hemorrhage is associated
with: Vacuum delivery alone, cesarean delivery with labor, cesarean delivery without labor, or forceps
delivery alone.
Cesarean delivery without labor.
❍ True or False: Ophthalmologic screening should be performed in all vacuum and forceps deliveries.
False.
❍ According to the ACOG practice bulletin, the lowest rate of neonatal death is associated with: Vacuum
delivery alone, cesarean delivery with labor, cesarean delivery without labor, or forceps delivery alone.
Vacuum delivery alone.
❍ True or False: The vacuum extractor is associated with an increased incidence of complications including
neonatal cephalohematoma, facial nerve palsy, retinal hemorrhages, and jaundice when compared with
forceps delivery.
False. Neonatal cephalohematoma, retinal hemorrhages, and jaundice are greater with the vacuum extractor but
facial nerve palsy is increased with forceps delivery.
❍ True or False: Assuming that there is adequate operator experience, both forceps and vacuum extractors are
acceptable and safe instruments for operative vaginal delivery.
True.
❍ The definition of nonrotational low forceps requires (two-part answer)?
Leading point of fetal skull is at station ≥+2 cm and rotation is 45 degree or less.
❍ The single greatest risk factor for third- or fourth-degree lacerations is?
The performance of a median episiotomy.