Vacuum extraction

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VE mark (impression of the suction cup) after the birth.

A vacuum extraction (colloquially Saugglockenentbindung ) at vaginal operative deliveries in the obstetrics used.

Instruments

The vacuum extractor consists of a pump, a vacuum bottle, the hose system and suction bells in various sizes and materials (metal, plastic, rubber and silicone). Small hand pumps, such as the Mystic suction bell or Kiwi bell , are also in use.

indication

Reasons for vacuum extraction are the child's hypoxia , exhaustion of the parturient or combined indications. Important prerequisites for performing the vacuum extraction are that the child's head reaches the middle of the pelvis or a lower pelvic level, the exclusion of a disproportion between the maternal pelvis and the child's head, and the exclusion of a forehead or facial position . Alternatively, forceps can be used in this situation .

technology

The largest possible suction cup is inserted into the vaginal entrance and placed on the child's head. The vacuum builds up as slowly as possible . The seat of the bell is checked and a test pull is used to check whether the child's head follows the pull. The child's head develops in several contractions synchronized with the labor . The extraction can be supported by the Kristeller handle . The vacuum should also be released slowly to avoid pressure fluctuations in the child's head.

Complications

The so-called head tumor , a swelling of the subcutaneous tissue under the bell, is normal and harmless after a suction bell birth . In children, however, pressure fluctuations in the head can also lead to bleeding into the skull or scalp ( cephalic hematoma 12% ). Abrasions and hematomas of the skin and temporary paralysis of the facial nerves are also mentioned. Serious complications are skull fractures and intracranial bleeding. Children born via vacuum extraction have significantly worse Apgar and Base Excess values ​​than children born via caesarean section or natural birth. Maternal injuries are perineal, vaginal and cervical tears.

history

The first sufficiently adhering vacuum bell jar was constructed in 1954 by Tage Malmström .

statistics

Vacuum extractions in German hospitals
year
Women giving birth		 of which by
vacuum extraction		 proportion of
1994 757.693 42,893 5.7%
1995 749.086 40,465 5.4%
1996 778,900 40,850 5.2%
1997 795.724 40,339 5.1%
1998 766.508 38,470 5.0%
1999 750.617 30,736 4.1%
2000 746.625 35,500 4.8%
2001 715.136 32,486 4.5%
2002 698.410 30,639 4.4%
2003 687.508 28,928 4.2%
2004 682.767 29,405 4.3%
2005 664,597 29,227 4.4%
2006 652,642 29.206 4.5%
2007 664.454 30,836 4.6%
2008 662.783 31,895 4.8%
2009 644.274 33,418 5.2%
2010 656.390 34,753 5.3%
2011 642.197 35,626 5.5%
2012 653.215 36,959 5.7%
2013 661.138 38,534 5.8%

Source: Federal Statistical Office

The number of vacuum extractions is not recorded in the nationwide obstetrics quality assurance process of the Institute for Quality Assurance and Transparency in Health Care and is therefore not used for the quality assessment of a clinic.

literature

Individual evidence

  1. ↑ Joachim W. Dudenhausen: Practical obstetrics: with obstetric operations . Walter de Gruyter, August 29, 2011, ISBN 978-3-11-022869-4 , pp. 307-310 (accessed July 19, 2013).
  2. ↑ C. Ekéus, U. Högberg, M. Norman: Vacuum assisted birth and risk for cerebral complications in term newborn infants: a population-based cohort study. In: BMC pregnancy and childbirth. Volume 14, January 2014, p. 36, doi : 10.1186 / 1471-2393-14-36 , PMID 24444326 , PMC 3899386 (free full text).
  3. ^ Bavarian Quality Assurance in Obstetrics 2016
  4. ↑ Share of caesarean sections in 2013 almost unchanged at 31.8 percent. In: www.destatis.de Press releases - Federal Statistical Office (Destatis). September 26, 2014, accessed April 6, 2016 .
  5. ^ Institute for Quality Assurance and Transparency in Health Care - Obstetrics