The use of vacuum during childbirth. Consequences of vacuum extraction during childbirth. Pros and Cons of Vacuum Extraction

natural childbirth for a woman - a process that takes a lot of strength, but as a result, a baby is born. For the sake of this, you can endure any pain and torment. Childbirth does not always go smoothly, there are situations when surgical procedures are indispensable. Among them, the vacuum extraction of the fetus. The process is quite complex. The doctor must have great professionalism in order to carry out the manipulation without consequences for the mother and child. When can a vacuum be used? What are the consequences this method delivery? These questions are answered in the article.

Understanding terminology

So, what is vacuum fetal extraction? This is delivery using a special device that captures the baby's head and thereby helps him pass through the birth canal. There are several types:

Maelstrom apparatus. It consists of metal cups, their diameter is from 15 to 80 millimeters. It is used quite rarely, the device is dangerous for the baby. Often there are injuries to the scalp, bones of the skull.

A more modern apparatus is Chachaev and Vashakidze. In this case, the vacuum is presented in the form of a rubber cap that captures the baby's head.

Each maternity ward has such devices. They are rarely used because they are Great chance harm the child. This can manifest itself in the form of neurological problems, damage to the integrity skin and much more.

A modern vacuum apparatus consists of a pear, which is made of silicone, it is no larger in size than chicken egg. Through the vagina, the doctor places it to the baby's head, after which a special hose is connected to the pump. The operation is only experienced doctor to minimize the risk to the child. You can use the device only during contractions, and during the break it is better to remove the device so that there are no bedsores on the baby’s head. For this, a special valve is built into it, which freely disconnects the vacuum.

If there are complications during childbirth, the doctor must act immediately to save the mother and child. If the baby does not move through the birth canal, the application vacuum apparatus justified.



Preparing for the operation

Many women in labor are worried about complications and unforeseen situations. Even the best and most qualified obstetricians and gynecologists cannot promise that the process will pass smooth. Sometimes there are situations that do not depend on a woman or doctors. If contractions or attempts suddenly stop, and the baby is already in the birth canal, specialists need to apply a vacuum. Such a delivery operation does not require almost any special training for woman. Doctors and nurses will do everything for her.

Firstly, a catheter will be placed, after which anesthesia will take place (injection of novocaine or Secondly, the doctor will need to know the exact location of the fetus. It can be determined using an ultrasound machine or manually. After all the manipulations, when the device is attached to the baby’s head, the woman in labor all doctor's recommendations must be followed.

Indications for use

Each maternity ward is equipped with everything necessary to help women in the difficult process. Vacuum machines are no exception. V last years they are used quite rarely, but still there are situations when it is almost impossible to do without them:

1. Abruptly ended contractions and attempts that are not caused by oxytocin.

   Endometritis.

Obstetric forceps are not entirely safe. The doctor performing the operation must have great professional skills and experience in such manipulations.



Which is safer: forceps or vacuum?

On the forums you can often see the question: “What do doctors most often use for complications in childbirth?” There is no single answer to it. It all depends on the situation and experience of the doctor. So, the use of vacuum is less traumatic for a woman. The rupture of the vagina is much less common. As for anesthesia, it will be needed in any case. As a rule, novocaine is used. unacceptable, as the woman must be conscious.

Another plus of a vacuum is that it is safer for a child to use it. Forceps can break the skin and cause significant harm to the baby. There are cases when doctors use several methods during delivery. V this case the scheme should be as follows: the imposition of forceps, and then the vacuum. If this does not help, doctors need to conduct an emergency C-section.



Vacuum extraction of the fetus is used only in extreme cases. Unfortunately, the statistics of using this device is not very encouraging. The risks of injuring a child are quite high.

What is vacuum fetal extraction?

Vacuum birth, what is it?

In the process of weak labor activity, when the efforts of the woman in labor do not bring desired result, due to weak contractions and attempts, they resort to the use of a special vacuum apparatus. Why is it necessary? By various reasons(we will look at them a little later) urgent help woman in labor in pushing out the baby. And the vacuum extractor just does help to pull the baby out of the birth canal.

The device operates as follows: a vacuum cup is inserted into the vagina and leaned against the head, then pressure is created, which pulls the bladder out. However, the consequences can be very unpleasant and sad for the child, therefore, such a procedure is resorted to in extreme cases, and then only doctors with great experience behind them. Often, the vacuum aspiration method is also used for missed pregnancy or spontaneous miscarriage in order to extract the fertilized egg.

Vacuum delivery indications

Agree, if the risks of complications are so high, then the use of a vacuum should be justified. What indications make doctors and obstetricians resort to such a serious method?

• acute oxygen starvation crumbs;
• a sharp decrease in heart rate in a baby;
• endometritis;
• weak generic activity that cannot be stimulated in a medical way(for example, with the help of oxytocin).

If a woman cannot strain and push hard for any reason (problems from of cardio-vascular system, increased eye pressure, etc.), then it is indicated. That is why it is so important to warn your gynecologist leading a pregnancy in advance about various features and problems of your body, as well as visit narrow specialists to decide on the method of delivery. If the doctor insists on a caesarean section, there is no need to refuse, because no one is offered to go under the knife just like that. This means that due to the problems of your body, a difficult course of childbirth is possible, and therefore you will have to resort to different kind stimulation and manual assistance, in particular to vacuum method extraction, which is much worse than a caesarean.

Pros and Cons of Vacuum Extraction

What conditions allow the baby to be pulled out with a vacuum?

• live baby;
• term pregnancy;
• the size of the head does not exceed the size of the pelvis;
• the head of the fetus descended into the small pelvis;
• the woman is conscious, her mind is not clouded, she is able to follow the doctor's commands.

Only if absolutely all conditions are met is it possible to use such radical method pulling out the crumbs. If at least one item does not match your situation, then use vacuum extraction FORBIDDEN!

What are the contraindications for this procedure?

• • inability to push;
  • early childbirth;
  • the child goes not with the head, but with the buttocks, or an incorrect head presentation;
  • the size of the head does not correspond to the size of the pelvis;
  • preeclampsia;
  • insufficient disclosure (less than 10 cm);
  • stillbirth.

Consequences

Often, during this mini-operation, the cup slips off the child's head, which is fraught with injury to the tiny head and the development of complications. However, complications can arise even with a perfectly performed procedure!

What are the consequences for the child when using such unsafe method delivery, even if the doctors themselves try to resort to this procedure in extremely rare cases, in the absence of the opportunity to conduct another, more safe way stretching baby?

The consequences may be medium degree gravity:

• • • damage to the scalp;
    • jaundice;
    • hemorrhage of the vessels of the eyes.

And extremely heavy:

• • • cephalohematoma;
    • intracranial pressure;
    • facial deformities;
    • epilepsy;
    • head injury or spinal cord;
    • various neurological diseases;
    • convulsions;
    • delay in emotional and / or psychological development;
    • various damage nervous system;

Very often, after vacuum extraction, a hematoma occurs in the back of the head of the baby, which itself resolves and does not cause any harm to the development and life of the crumbs. But this is the most positive scenario for the development of events. Statistics show that complications occur in about half of the cases. Therefore, this intervention birth process, even if with a good purpose, should be very well weighed.

Consequences for mother:

• • • various kinds of breaks (birth canal, perineum);
    • the development of infections;
    • increase in the period of postpartum recovery;
    • deformity of the external genitalia.

Many women note after this method of delivery.

Dear readers, everyone wants every child in this world to be healthy and have the opportunity to enjoy life, right? That is why it is necessary to carefully approach the issues of planning and carrying a pregnancy, as well as delivery. Therefore, if you are aware of your health problems that may interfere normal process childbirth, it is necessary to discuss this with the doctor in advance.

I really hope that each of you will be a happy mother of a healthy and cheeky toddler. Health to you and your crumbs! All the best! See you!

Vacuum extraction is used for acute shortage oxygen or with weak labor activity that cannot be corrected medicines(prostaglandins or). To exclude unfavorable, observe following conditions carrying out vacuum extraction of the fetus: uterine os must be completely open, the child must be alive, his head must be in the birth canal.

Vacuum extraction of the fetus is carried out as follows. A catheter is inserted into a woman in labor bladder, apply anesthesia, perform an examination of the birth canal. Then he opens the entrance to the vagina with one hand, and with the other hand inserts the cup of the device inside, places it on the child's head, creates a negative pressure in the cup. Then, at the command of the doctor, the woman in labor begins to push, and the doctor at this time must pull the fetus out.

Vacuum delivery do not use with an unopened uterine pharynx, if it is too high, and also if the child or fetus is premature. Contraindications for vacuum extraction are also: serious condition women in labor, which excludes the possibility of attempts, delivery ahead of time, discrepancy between the size of the baby's head and the woman's pelvis, extensor types of fetal presentation.

Vacuum extraction is not used if the woman in labor is forbidden to push for certain indications.

What are the consequences of vacuum extraction

Vacuum extraction is not a very effective and traumatic procedure, therefore, in most cases, cesarean is used instead. May be damaged during vacuum delivery tender baby. If the procedure is delayed, to save the life of the baby, he will have to be pulled out with forceps. Other consequences of vacuum extraction are the slipping of the cup of the baby's apparatus, the lack of movement of the child along the birth canal, and birth injuries of the baby.

During vacuum extraction, the uterus and vagina of the woman in labor can be injured.

Consequences birth injury can be varied: cerebral hemorrhages, paresis, paralysis, convulsions, retarded growth and development of the limbs, impaired muscle tone, hydrocephalus, intracranial hypertension, hypertension syndrome, cranial nerve damage, perinatal encephalopathy(PEP), cerebral paralysis(cerebral palsy), delay speech development, delay psychomotor development, pneumonia, minimal cerebral dysfunction, urosepsis.

Extraction of the fetus with a vacuum or vacuum extraction of the fetus is a delivery operation, with the artificial extraction of the fetus using a vacuum extractor through the natural birth canal.

In this case, a negative pressure is created in the device between the fetal head and inner surface cups.

The device includes a sealed buffer tank with a pressure gauge, a hand pump, which creates a negative pressure, and a set of applicators. In particular, in the apparatus of Maelstrom, this is a set of metal cups ranging in size from fifteen to eighty millimeters, and in the apparatus of E.V. Chachava and P.D. Vashakidze, this is a rubber cap.

It should be noted that in our time, vacuum extraction of the fetus is used quite rarely, due to the relatively high probability adverse effects for the fetus. It is allowed to use vacuum extraction only in the absence of conditions for the implementation of other delivery operations.

Indications for vacuum fetal extraction

Compared to an operation in which obstetrical forceps are applied, vacuum extraction of the fetus requires Active participation women in labor during this procedure, in connection with this, the number of indications for vacuum extraction of the fetus is limited.

These indications include the ineffectiveness of conservative therapy, in which it is not possible to overcome the weakness of labor and the onset.

Contraindications for vacuum extraction

There are also a number of significant contraindications for this operation. These include states:

• decompensated heart defects,
• severe forms of gestosis,
• hypertonic disease,
• , since the vacuum extraction of the fetus requires active work of the woman in labor in the form of attempts.

Other contraindications include:

• prematurity of the fetus, when childbirth is accepted for periods of less than thirty-six weeks,
• discrepancy between the size of the pelvis of the mother and the head of the fetus,
• as well as extensor presentation fetal heads.

The physical action of the vacuum extractor has a number of features that do not allow the device to be used in the last two cases. Here the placement of the cups in the area large fontanel or on the head premature fetus can lead to very serious consequences.

Under what conditions is the vacuum extraction operation performed?

For the operation to be carried out, a number of conditions must be met. Firstly, the fetus must be alive, while the cervix must be completely open. There must be a match in the size of the fetal head and the mother's pelvis, amniotic sac should be absent. There must be an occipital protrusion, it is necessary that the fetal head is a large segment at the entrance to the small pelvis in the cavity of the small pelvis.

Consequences of Vacuum Extraction

The most common complication of the operation is slipping of the calyx from the head of the fetus, this is possible if there is a violation of the tightness in the device. In addition, cephalo hematomas and cerebral symptoms are often observed on the fetal head.

Even in the early days of vacuum fetal extraction, there were fears that the bone would pop out or the baby's skull would be torn.

In fact, many cases are known when these prophecies of obstetricians of former times came true. The use of vacuum machines was justified on the grounds that replacing the steel forceps would help alleviate the awkwardness of using forceps by some inexperienced obstetricians.

This explains the popularity of this method during certain period time.

After that, the era of increased interest in vacuum extraction was replaced by an era of clearly negative attitude to this operation.

Studies have shown the presence of damage to the nervous system of the fetus in 60% of children born using the vacuum extraction method, it was determined in every fifth, and neurological signs spinal cord injury in the form of spastic tetraparesis, myatonic syndrome, obstetric paralysis, was determined in 23.4% of babies.

Vacuum can be used during childbirth and after, if the contractile function of the uterus is impaired in women. These are completely different manipulations.

The purpose of vacuum extraction is to extract a live fetus when a caesarean section is performed on this stage impossible. The device for influencing during childbirth consists of a buffer tank equipped with a pressure gauge, a hand pump and a set of applicators of various sizes.

Currently, there are several modifications of such devices: E.V. Chachava, Malstrem and P.D. Vashakidze. The bowls of the Maelstrom apparatus are made of metal, the rest of the designers suggested rubber for the manufacture of bowls.

The postpartum vacuum apparatus consists of a syringe with a catheter attached to an apparatus or hand pump that creates negative pressure in the uterine cavity.

Vacuum delivery and vacuum cleaning after childbirth are completely different manipulations. In the first case, this is the extraction of the fetus, in the second, scraping.

Vacuum delivery

In contrast to the overlay of forceps, vacuum exposure during childbirth cannot be carried out without the participation of the woman in labor.

Indications for this procedure:

• acute hypoxia in the fetus, when it is already in the birth canal;
• weak labor activity, which cannot be corrected with the help of medicines;
• cessation of contractions and attempts during the movement of the fetus through the birth canal.

Vacuum extraction is carried out according to the following algorithm.

1. A woman in labor, who is conscious, is injected into the bladder with a catheter with anesthesia;
2. At the same time, an examination of the birth canal is carried out;
3. Further, a lot depends on the qualifications of the obstetrician. He should by touch, having opened the entrance to the birth canal, place the cup of the device on the head of the child with one hand, holding the entrance to the vagina with the other;
4. The doctor at this time, using a hand pump or a mechanical apparatus - the second is used quite rarely in order to avoid unnecessary injuries - creates a negative pressure.

The woman in labor begins to push on command, helping the fetus to be pulled out by the extractor.

Contraindications for vacuum fetal extraction are:

• late preeclampsia;
• heart defects in the stage of decompensation;
• arterial hypertension;
• myopia to a high degree;
• extensor presentation of the fetal head;
• childbirth before 36 weeks;
• discrepancy between the size of the fetal head and the mother's pelvis.

Improper placement of the cup on the head of the fetus, which caused compression of the large fontanel, can cause quite serious consequences.

Vacuum birth - possible consequences for the child

Currently, they try to resort to vacuum extraction only in extreme cases, appointing a caesarean section, if the possibility of complicated labor activity is allowed.

The consequences of childbirth with a vacuum are most often lesions of the nervous system - in 60% of cases, the appearance of a neurological syndrome - obstetric paralysis or tetraparesis - in 23.7% of newborns. In 1 case out of 5 brain injuries are diagnosed.

Hematomas remain on the head of the child after the use of vacuum obstetrics. If the seal is broken, the cup may slip off the fetal head.

The invention of the vacuum apparatus was once declared an obstetric breakthrough - it seemed that this method was the most gentle, compared with the application of forceps. It seemed that even inexperienced obstetricians would be able to do without injuries. As it turned out, this method is no better than time-tested forceps, and no less traumatic.

How can you answer the question: "Which childbirth is better to carry out, caesarean or vacuum?". The method is chosen by the doctor, depending on the clinical picture. Vacuum extraction is not an operation, it is obstetrics in a critical case. Manipulations help save the life of the baby and mother, if medications and other methods cannot be applied.

Vacuum aspiration

The state of health of the puerperal largely depends on how the 3rd stage of childbirth went - the separation of the placenta. Remains fetal membrane later expelled by natural uterine contractions.

If the contractions are not intense enough, then the bleeding slows down, foreign tissue inclusions remaining in the uterus form a favorable nutrient medium for active development pathogenic microorganisms that cause purulent-inflammatory processes.

The remnants of foreign tissues and accumulated clots do not allow the uterus to contract, which can provoke the development serious illnesses such as endometritis.

On the 3-5th day after childbirth - at present, this is more often done before discharge from the hospital - an ultrasound examination is performed on the woman in labor, in which the state of the uterine cavity is determined. Some 20-25 years ago, the examination was carried out on a chair, but using ultrasound to describe clinical picture much more accurate.

In the presence of foreign tissues in the uterine cavity, cleaning is prescribed. What methods will be chosen for curettage - the decision is made by the doctor.

Vacuum cleaning - compared to manual cleaning - is considered the most gentle procedure. However, it is not performed if a woman has uterine malformations or neoplasms, gynecological infections, in the case when curettage was performed before pregnancy, regardless of the reasons for the surgical intervention.

How does vacuum aspiration work?

The procedure can manually or hardware. In the first case, the doctor creates a negative pressure in the uterine cavity using a hand pump, in the second case, a syringe with a catheter is connected to an electric blower.

Cleaning after childbirth is technically no different from a conventional vacuum operation.

The woman is placed on a gynecological chair, the external genital organs are treated with an antiseptic solution.

A gynecological speculum is inserted into the vagina, and a preoperative examination is performed. At this stage, intravenous or intrauterine anesthesia is usually administered, since the installation of bullet forceps and a dilator causes severe pain.

Then the cervix and upper lips fixed with bullet forceps, a probe is inserted into the cavity to determine the internal dimensions of the uterus.