Ventouse

Ventouse is a vacuum device used to assist the delivery of a baby when labour has not progressed adequately. It is an alternative to a forceps delivery and caesarean section. It is not usually used when the baby is in the breech position or for premature births. This technique is also called vacuum-assisted vaginal delivery or vacuum extraction (VE). The use of VE can have negative effects on both the mother and the child. [ [http://www.emedicine.com/med/topic3389.htm eMedicine - Vacuum Extraction : Article by Christian S Pope, DO] Retrieved December 16, 2006]

Technique

The woman is placed in the lithotomy position and assists throughout the process by pushing. A suction cup is placed onto the head of the baby and the suction draws the skin from the scalp into the cup. Most ventouse devices have handles and when the head is born the device can be detached, allowing the woman to complete the delivery of her child.

Some ventouse births have been conducted before the cervix was fully dilated though some medical practitioners disagree whether this should be done.

If the ventouse attempt fails it may be necessary to deliver the infant by caesarean section.

Indications for use of vacuum

There are three generally accepted indications to use a ventouse to aid delivery:
*Prolonged pushing in the second stage of labor or maternal exhaustion
*Fetal emergency in the second stage of labour, generally indicated by changes in the fetal heart rate
*Maternal illness where "bearing down" or pushing efforts would be risky (e.g. cardiac conditions, blood pressure)

Comparisons to other forms of assisted delivery

Positive aspects

*An episiotomy is not usually required and there is little internal bruising.
*The mother still takes an active role in the birth.
*The force applied to the baby can be less than that of a forceps delivery, leaving less marking on the head and face.

Negative aspects

*The baby is left with a temporary lump on its head, known as a chignon.
*The baby may become distressed due to strong suction to its head.
*The babies skull may become tense and disallow movement of the skull bones leading to various issues such as diarrhoea. Some hospitals recommend therefore an immediate examination using osteopathy. [Wickham, Sara (2003): Midwifery: Best Practice, Elsevier Health Sciences, ISBN: 0750654279, p.209 (online: http://books.google.com/books?id=PvRo4rJ1UEUC&pg=PA209&dq=ventouse+osteopathy&sig=ACfU3U1R9bSAi758c8LAsnHcbg0OK23l6w)]

References