Ultrasound Examination Before Vacuum Extraction

The cesarean section rates are rising and much higher than medical indicated [1]. Cesarean section is associated with risks of uterine rupture, abnormal placentation, ectopic pregnancy, stillbirth, and preterm birth in subsequent pregnancies [2]. Avoiding the first cesarean influences delivery mode in subsequent deliveries. WHO recommends that every effort should be made to provide cesarean sections to women in need, rather than striving to achieve a specific rate. The risk for complications is highest when performed at low stations, and a vacuum extraction may be a safe alternative. Levine et al. has shown a sixfold increase in preterm birth in subsequent deliveries following a second-stage cesarean section [3]. In many countries there is an underuse of operative vaginal deliveries [4]. More use of vacuum extractions has the potential to reduce the rate of cesarean sections, and both pediatric and maternal benefits may be achieved.