What indicates the use of vacuum-assisted delivery?

The use of vacuum-assisted delivery is indicated primarily in situations involving an extended second stage of labor. This stage is considered prolonged when the mother has been pushing for an extended period without progress, typically defined as more than two hours for a nulliparous woman or more than one hour for a multiparous woman.

In such cases, vacuum assistance can help facilitate the delivery of the fetus by providing traction during contractions, assisting the fetal descent, and reducing the risk of maternal fatigue and fetal distress. Essentially, this intervention is employed to expedite delivery when it is crucial to avoid adverse outcomes for both the mother and the baby, such as infection or fetal compromise.

Other situations mentioned, such as cephalopelvic disproportion, uncertain fetal station, or advanced cranial molding, are more complex and may not be appropriate or safe for vacuum assistance. For instance, if there is a significant mismatch between the size of the fetus and the maternal pelvis (cephalopelvic disproportion), a vacuum-assisted delivery may not effectively resolve the issue and could pose risks. Thus, the extended second stage of labor stands out as the most relevant and appropriate context for considering a vacuum-assisted delivery.