Indications and case selection must be appropriate to avoid maternal and/or foetal injuries.

These include:

  • Poor maternal effort.
  • Delayed second stage (within 30 minutes from full dilatation) in the absence of CPD.
  • Cord prolapse in 2nd stage.

Requirements for vacuum delivery are:

  • Cephalic presentation
  • Full cervical dilation
  • Low head (good descent)
  • Empty bladder
  • Episiotomy

Contraindications for vacuum delivery are:

  • CPD
  • Previous caesarean or myomectomy scar
  • Malpresentation (breech, transverse lie, oblique, etc.)
  • Malpositions (brow and face malpositions)