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Operative Vaginal Delivery
The Use of Vacuum Extractors and Forceps During Childbirth
By Suzy Feine
Some health risks are associated with operative vaginal delivery. While serious fetal injuries are rare, they can occur with both vacuum extractors or forceps.
For the baby, a few complications can occur with operative vaginal delivery. "Hemorrhage into the subgaleal/subaponeurotic space is a potentially serious birth injury with a reported incidence of 9.5 out of every 1,000 births, with approximately half related to vacuum operations," says Dr. Pope. Other complications can occur that may or may not be related to instrument delivery. "Intracranial hemorrhage (bleeding inside the baby's head) may result from the events of labor leading to the dystocia, requiring operative intervention, and may not be directly due to the instrumental delivery," says Dr. Pope.
For the mother, perineal lacerations and trauma, as well as episiotomy extensions can occur during operative vaginal delivery. Perineal trauma can potentially injure pelvic nerves or disrupt the anal sphincter, resulting in permanent pelvic floor dysfunction. "The women at greatest risk are those who have experienced a laceration in the first delivery followed by a subsequent delivery combining both instrumentation and episiotomy," says Dr. Pope. "Close attention to detail, unhurried delivery, prompt recognition and skillful repair of injuries are paramount."
"The possibility of an operative vaginal delivery, however, should not instill fear into the end of the third trimester of the expecting mom," says Dr. Pope. "She should work in concert with her obstetrician throughout her pregnancy and labor and put good faith in her doctor's judgment."
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