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Operative Vaginal Delivery

2010; Lippincott Williams & Wilkins; Volume: 115; Issue: 3 Linguagem: Inglês

10.1097/aog.0b013e3181cfbefd

1873-233X

Edward R. Yeomans,

Surgical Simulation and Training

In Brief Operative vaginal delivery remains a valid option when problems arise in the second stage of labor. The most common indications are fetal compromise and failure to deliver spontaneously with maximum maternal effort. There is a clear trend to choose vacuum extraction over forceps to assist delivery, but the evidence supporting that trend is unconvincing. Recent literature confirms some advantages for forceps (eg, a lower failure rate) and some disadvantages for vacuum extraction (eg, increased neonatal injury), depending on the clinical circumstances. To preserve the option of forceps delivery, residency training programs must incorporate detailed instruction in forceps techniques and related skills into their curricula. Simulation training can enhance residents' understanding of mechanical principles and should logically precede clinical work. Operative vaginal delivery remains an acceptable method for delivering neonates.