Vacuum extractor: a safe instrument?

One thousand five hundred and twenty-six records of deliveries with vacuum extractor in 1982 and 1983 in the Hong Kong University Department of Obstetrics and Gynaecology were reviewed. Vacuum extractor was found to be easy and safe to use even by inexperienced house-staff. Vacuum extractor was especially useful in the delivery of malpositioned fetal heads because of its mechanism of allowing autorotation. Its advantage of not occupying extra space in the pelvis was most beneficial to the relatively smaller Chinese pelvis. Maternal injury was uncommon. Fetal scalp injury like cephalhaematoma was not uncommon but serious scalp injury was infrequent. Perinatal mortality rate attributed to the instrument was low (0.6/1,000). However, in order to achieve safety to the mother and fetus, strict rules in application of the vacuum extractor must be observed.