Question

You are counseling a 22-year-old G1 who is at 38 weeks gestation. She has been pushing for four hours and you recommend a trial of forceps. She asks whether a vacuum-assisted delivery is associated with a lower incidence of maternal and fetal trauma. Which of the following is less likely to occur during a vacuum delivery?

1) Maternal lacerations
2) Fetal cephalohematoma
3) Neonatal lateral rectus paralysis
4) Neonatal hyperbilirubinemia
5) Neonatal retinal hemorrhage

Answer 1

Maternal lacerations are less likely during a vacuum-assisted delivery compared to forceps delivery, due to the design and application method of the vacuum.

Step-by-step explanation:

When it comes to instrumental delivery, both vacuum extraction and forceps deliveries are associated with certain risks to the mother and the newborn. In particular, maternal lacerations are less likely to occur during a vacuum delivery than with the use of forceps. Forceps, due to their design, require more space and can exert more direct pressure on the maternal tissues, increasing the likelihood of lacerations. The other complications listed, such as fetal cephalohematoma, neonatal lateral rectus paralysis, neonatal hyperbilirubinemia, and neonatal retinal hemorrhage, can potentially be associated with both vacuum and forceps deliveries, but there is no clear evidence that vacuum extraction significantly reduces the incidence of these outcomes compared to forceps. Therefore, the response to the student's question is 1) Maternal lacerations are less likely to occur during a vacuum delivery.