Vacuum births given backing in latest safety study

USING a vacuum to help deliver a child is as safe as using a forceps during difficult deliveries, new research indicates.

In the late 1990s, US safety watchdog the FDA warned that vacuum-assisted deliveries may result in fatal complications, particularly bleeding in the brain.

But research by Kitaw Demissie, assistant professor at the University of Medicine and Dentistry of New Jersey, found that while vacuum extraction has risks, it remains a safe alternative to using forceps.

The research also called for better obstetric standards when using forceps and vacuums during deliveries.

Examining almost 200,000 births in two different locations, Prof Demissie found that vacuum delivery was associated with a lower risk of birth injuries, neonatal seizures, and the need to help the baby with its breathing.

However, in New Jersey, vacuum extraction was more likely than forceps to be complicated by postpartum haemorrhages (where the mother starts to bleed after the birth), and shoulder dystocia (injuries to the baby’s shoulders).

The risks of intracranial haemorrhages (bleeding to the brain), difficulty with feeding, and retinal haemorrhage (bleeding in the eye), were comparable between forceps and vacuum delivery. The sequential use of vacuum and forceps was associated with an increased risk of the need for the mechanical ventilation of the infant and perineal tears for the mother.

The research, published yesterday in the British Medical Journal, said the consistency of results from two data sources covering different periods adds credibility to its conclusions.

Prof Demissie said difficult deliveries in which the use of the vacuum was followed by forceps, or when either procedure was followed by caesarean section, had worse outcomes than procedures that were successful on the first attempt.

The research pointed out that in more than 10 000 deliveries in Britain, the use of multiple instruments and more than three pulls at attempted instrumental delivery were associated with increased neonatal trauma.

“Although delivery by vacuum extraction does have risks, it remains a safe alternative to forceps delivery. Our results underscore the need for obstetric standards in performing instrumental deliveries,” the research concluded.