Is Vacuum Delivery Safe?

When there are problems with normal spontaneous vaginal deliveries, assistance may be needed to help complete the vaginal delivery. The most common methods of assisted delivery, also called operative delivery, are vacuum extraction and forceps delivery. Both methods use tools to help pull the baby through the birth canal. Vacuum delivery is used more commonly than forceps. About 10 percent of births are assisted with vacuum extraction.

Assisted vaginal deliveries are typically initiated when:

• There is concern for either the mother’s or the baby’s well-being;

• The labor is not progressing well enough; or

• The mother is too exhausted to continue pushing.

How Vacuum extraction Works

A cup attached to a vacuum pump is placed on the head of the baby. The cups can be made of plastic or metal and vary in their relative rigidity or softness. Rigid cups are more likely to result in successful assisted deliveries, but are also more likely to cause injuries to the baby. A vacuum pump creates the suction or vacuum seal in the cup needed to help pull the baby.

Risk of Injury from Vacuum Extraction

Recent studies suggest an increased risk of certain injuries or complications from vacuum birth for the baby and mother. In addition, there are several factors that can increase the risk of injury, that medical personnel have some control over, such as suction pressure, placement of the suction cup, duration of suction, age of the fetus being delivered (no less than 34 weeks; preferably at least 37 weeks of gestational age), and adequate pelvic to head ratio between the mother and baby.

Increased Injury Risks for Babies

The following birth injuries have a higher risk of occurring in vacuum assisted deliveries:

• Scalp trauma – bruises or abrasions on scalp

• Cephalohematoma – pooled blood next to the baby’s skull which is normally reabsorbed within a couple of weeks to three months. As red blood cells are broken down increased production of bilirubin occurs, which is increases the risk of jaundice.

• Skull fracture – although rare, severe cephalohematomas can occur as a result of a skull fracture during assisted delivery.

• Brachial plexus injury – nerve damage causing paralysis to arm, hand or fingers)

• Retinal bleeding – bleeding at the back of the eyes.

• Intracranial bleeding – bleeding in the brain caused by ruptured blood vessels

• Intra-ventricle bleeding – intracranial bleeding in the ventricles (fluid-filled spaces) of the brain

• Subgaleal hemorrhage – a rare but dangerous condition whereby a large volume of blood from damaged blood vessels collect between the periosteum (connective tissue covering bones) and the scalp. Swelling continues after birth and the condition often be diagnosed until after the first several hours, or few days of life. It is frequently associated with cephalohematoma and intracranial bleeding and can go undetected and misdiagnosed. If not detected within few days, anemia, metabolic acidosis (excess acidity in the blood), and respiratory distress develop causing death.

Injury Risks for the Mother

The risk of injury to the mother using vacuum extraction is low. There may be stretching and tearing of tissues, hematomas, and damage to the pelvic floor.

Is Vacuum Extraction Safe?

The incidence of birth injuries, especially cephalohematoma, intracranial hemorrhage, and retinal hemorrhage, are more likely to occur with vacuum births compared to normal spontaneous vaginal births and to births assisted with forceps. Injury to the baby is more likely to occur due to physician technique errors. Despite the increased risk to the baby, and a Public Health Advisory insured by the U.S. Food and Drug Administration in 1998, many physicians believe that vacuum extraction is a safe and appropriate option for assisted delivery with a low rate of serious injury to the baby.

If you or your baby were injured during a vacuum extraction delivery, consult an experienced personal injury law firm, who can help you file a lawsuit and receive compensation and fees for your damages.

(Article from Birth Injury and Medical Malpractice Legal View)

Birth Injury: An Overview

Birth injury, or birth trauma, refers to any damage an infant sustains during the birthing process due to forces like compression or traction, or factors that restrict blood flow or oxygen intake. Fortunately, advances in technology and medical practices have greatly diminished the occurrence of birth injuries over time. In the U.S., there are an average of six to eight significant birth injuries per 1,000 live births, and these injuries contribute to fewer than two percent of neonatal deaths and stillbirths.

Injury is typically sustained during transit through the birth canal. The likelihood of injury increases when the birth canal is too small, or the fetus is too large (which can occur when the mother is diabetic) or is not ideally positioned before birth, such as with breech (buttocks first) delivery. Often, a cesarean birth is used to avoid complications from these factors, but cesarean sections carry risks, as well.

Prematurity can be problematic, as babies born before 37 weeks of gestation have more fragile bodies that are more easily injured. Prolonged labor can also be a factor.

Minor swelling or bruising of a newborn in some areas after vaginal birth is relatively common. This type of injury does not require treatment and heals on its own. Forceps can leave temporary marks or bruises on the face and head. More pronounced swelling of the soft scalp tissues is known as caput succedaneum. Babies delivered by vacuum extraction are more likely to have this condition, along with bruising and, sometimes, a scalp laceration, and the swelling usually disappears in a few days.

One or both of the eyes may have a bright red band around the iris due to subconjunctival hemorrhage, the breakage of small blood vessels in the eyes of a baby. This is very common and does not cause damage to the eyes. The redness is usually absorbed in a week to ten days.

Other categories of birth injuries include :

Head Injury

In normal births, the head comes through the birth canal firs and is subjected to much of the pressure of delivery. Swelling and bruising are not typically serious, and heal within a few days. With chepalohematoma, a soft lump caused by pooled blood forms over the surface of one of the skull plates, but below the thick, fibrous covering. It does not need treatment, and heals in weeks or months. Jaundice may occur if the area of injury is larger than, from the breakdown of the red blood cells as the injury heals. Rarely, a skull bone may fracture, but unless it forms an indentation, it needs no treatment and heals quickly.

Nerve Injury

Pressure to facial nerve can create weakness in the muscles of one side of the face, but recovery without treatment takes just weeks. Nerves to one or both arms can be injured, producing brachial palsy, or weakness or paralysis of the arm or hand. The nerve to the diaphragm can be injured, leading to difficulty breathing. Both types of injuries heal within weeks without treatment, but surgery may be needed to repair any torn nerves. Spinal cord injuries are very rare, but produce paralysis below the injury that is often permanent.

Bone Injury

In rare cases, bones may be broken or fractured during delivery, most commonly the collarbone. Healing is almost always rapid and complete.

Brain Injury

Permanent brain injury that occurs before, during or shortly after birth is known as cerebral palsy. It is caused by an interruption of normal blood flow (ischemia) and/or oxygen flow (hypoxia or asphyxia) before or during labor, around the time of birth, or during the first hours or days after delivery. It is characterized by a lack of muscle control and movement, and symptoms can include seizures, spasms, visual and hearing problems, hyperactivity, and learning disorders.

Factors that can contribute to developing cerebral palsy include :
- Diabetes,
- pregnancy induced hypertension,
- preeclampsia,
- preterm labor,
- chorioamnionitis,
- maternal infection,
- group B strep infection,
- placenta previa, and
- vasa previa.

There is no cure, but therapies are available for treatment.

Perinatal strokes occurs between the 28th week of gestation and the first month of life. It is likely related to the activation of coagulation agents during this time. The rate of stroke in infants is equal to that of the elderly, according to a University of California, San Francisco (UCSF) study – one in 5,000. This can lead to long-term neurological problems, including cerebral palsy, epilepsy, language problems and hyperactivity.

If your child suffered from a birth injury due to medical malpractice or negligence, you may be eligible for compensation. Contact can experienced birth injury lawyer to determine whether you wish to file a medical malpractice lawyer.


(Article from Birth Injury and Medical Malpractice Legal View)