Vacuum Extraction

Vacuum extraction delivery is a form of assisted vaginal delivery.  Medical providers apply a medical device – a vacuum extractor – to the baby’s head.  During contractions, the vacuum extractor is pressurized to create suction on the baby’s head.  The medical provider uses the vacuum extractor to pull on the baby’s head during contractions.  Vacuum extractors are potentially dangerous devices if used incorrectly or by inexperienced medical providers.  In 1998, the United States Food and Drug Administration issued a Public Health Advisory to doctors, nurses, hospital obstetric departments and risk managers warning that vacuum assisted delivery devices may cause serious or fatal complications to babies. Injuries that are known to be caused by vacuum extraction deliveries include subgaleal hemorrhage and intracranial hemorrhage.  Because of the potentially deadly injuries, the FDA recommended that the vacuum extraction devices be used ONLY WHEN A SPECIFIC OBSTETRIC INDICATION IS PRESENT and that the medical providers who use the device be versed in their use and aware of the indications, contraindications and precautions.

Some injuries caused by vacuum extraction include:

2. • Intracranial hemorrhage is a hemorrhage, or bleeding, within the skull. Intracranial hemorrhage occurs when a blood vessel in the head is ruptured or leaks. it can result from physical trauma to the head.

3. • Cephalohematoma is a hemorrhage or collection of blood caused by rupture of blood vessels between the skull and the periosteum. The extent of hemorrhage may be severe enough to cause anemia and hypotension. Cephalohematoma may be caused by a prolonged second stage of labor or by operative vaginal delivery with a vacuum extractor or forceps.

   • Subgaleal hemorrhage is bleeding in the potential space between the skull periosteum and the scalp galea aponeurosis. A large percentage of subgaleal hemorrhage result from vacuum extractors applied to the head at delivery. Subgaleal hematoma is also associated with head trauma, such as intracranial hemorrhage or skull fracture.  Patients with subgaleal hemorrhage may present with hemorrhagic shock and may develop hyperbilirubinemia. 

   • Caput Succedaneum is swelling of the scalp in a newborn baby usually caused by the mechanical trauma to the presenting part of the head being pushed through the cervix. Babies with caput succedaneum may become jaundiced when the bruising breaks down into bilirubin.