Indications and case selection must be appropriate to avoid maternal and/or foetal injuries.
- 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
Contraindications for vacuum delivery are:
- Previous caesarean or myomectomy scar
- Malpresentation (breech, transverse lie, oblique, etc.)
- Malpositions (brow and face malpositions)