Forceps or vacuum extraction? A comparison of effects on the newborn infant.

Sixteen women delivered by forceps and 20 women delivered by vacuum extraction (VE) owing to secondary uterine inertia were compared with a control group of 11 women who gave birth spontaneously. The cord arterial pH was lower in the VE group than in the forceps and control groups. Base deficit in both arterial and venous cord blood was greater in the VE group than in the forceps group, probably owing to the longer application and extraction times in VE than in forceps delivery. The incidence of retinal hemorrhage did not differ between the forceps and VE groups. The incidence of cephalhematomata was greater among VE infants than in the forceps and control groups. All infants were examined on the 1st and 5th day by standardized neurological and behavioural examination. There were no significant differences in neurological status between the forceps and VE groups. Thus, in low extraction with no signs of fetal asphyxia, either method can be used with safety if the obstetrician is familiar with both methods of operative vaginal delivery.