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Ventouse method

Extracted from Survival Guide to Midwifery, 2nd Edition (2012) Diane M. Fraser and Margaret A. Cooper, Oxford; Churchill Livingstone: 2012. Courtesy Elsevier

The ventouse method is a commonly used intervention in assisted vaginal birth. The ventouse is a vacuum extraction instrument that applies traction. It can be used as an alternative to forceps. The cup clings to the fetal scalp by suction and is used to assist maternal effort. It may be used when there is a delay in labour, when the cervix is not quite fully dilated. It may also be useful in the case of a second twin, when the head remains relatively high.

Procedure

  • The woman is usually in the lithotomy position; the same precautions should be observed as for a forceps birth
  • The cup of the ventouse is placed as near as possible to, or on, the flexing point of the fetal head
  • The vacuum in the cup is gradually increased to achieve close application to the fetal head, usually to 0.8kg/cm2
  • When the vacuum is achieved, traction is applied with a contraction and with maternal effort. Traction is applied downwards and backwards, then forwards and upwards, following the natural curve of the pelvis.
  • The vacuum is released and the cup is removed at the crowning of the fetal head.
  • The mother can then push the baby for the final part of the birth.

Complications

Prolonged traction will increase the likelihood of scalp abrasions, cephalhaematoma and subaponeurotic bleeding.

 

Further reading

Royal College of Obstetricians & Gynaecologists (2011) Operative vaginal delivery. Green-top guideline No 26. Available at: https://www.rcog.org.uk/globalassets/documents/guidelines/gtg26.pdf

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