ABSTRACT
Vacuum- and forceps-assisted deliveries have the same indications. There are no circumstances where operative vaginal delivery (OVD) is definitely indicated. OVD has been practiced for centuries. Its initial function was fetal extraction during prolonged dysfunctional labor in an attempt to preserve the life of the laboring woman. Rates of OVD have been declining in the United States. Both forceps and vacuum have the same indications. OVD should be used with extreme caution in women with maternal diabetes, prolonged labor, and fetal macrosomia, with appropriate preparations due to an increased risk of shoulder dystocia. Risks for failed vacuum or forceps vaginal delivery include increased maternal age, increased body mass index, diabetes, polyhydramnios, macrosomia, occiput posterior, dysfunctional labor, and prolonged labor. Vacuum extractors were originally designed with a rigid metal cup. There is a recognized place for forceps and all types of vacuums in clinical practice.
