Operative vaginal deliveries: Indications, techniques and complications

Stergios K. Doumouchtsis, Sabaratnam Arulkumaran

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

2 Citations (Scopus)


Operative vaginal delivery involves the use of the ventouse (vacuum extractor) or obstetric forceps to facilitate descent of the fetal head along the pelvic curve and delivery of the fetus. Ventouse delivery is performed by traction of the fetal scalp with a suction cup. Forceps cradle the parietal and malar bones of the fetal skull and apply traction, as well as laterally displace maternal tissues. The incidence of operative vaginal delivery in different countries varies between 10 and 15% [1,2]. Although the incidence has remained unchanged, ventouse has become more popular than forceps. Over the past two decades, in the United Kingdom, the use of forceps has decreased by 50% in favour of vacuum extraction or caesarean section [3]. In the USA, the rate of vacuum delivery exceeded the rate of forceps delivery in 1992 [2,4]. In Canada, forceps delivery has decreased in the last decade from 11.2% in 1991 to 6.8% in 2001 [5]. Although ventouse delivery is associated with a significant reduction of maternal morbidity compared to the use of forceps [6], it has higher failure rates (RR 1.7) [7,8], which is a concern in the light of the risks of sequential instrumentation for delivery [9]. Operative vaginal deliveries are classified by the station of the leading bony point of the fetal head and the degree of rotation of the sagittal suture from the midline.

Original languageEnglish
Title of host publicationBest Practice in Labour and Delivery
PublisherCambridge University Press
Number of pages11
ISBN (Electronic)9780511635489
ISBN (Print)9780521720687
Publication statusPublished - 1 Jan 2009


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