Vacuum-Assisted Delivery Devices

An Under-Reported Danger

September 3, 1999

With increasing frequency, physicians attending mothers during delivery employ a device often referred to as a vacuum extractor. A vacuum extractor is a suction-cup device that is applied to the top of the baby's head to help pull the baby through the birth canal. The device is employed for a variety of reasons, some appropriate and some not. In some cases, the physicians employing the vacuum-assisted delivery device do not provide the parents with detailed information about the risks associated with using this device.

On May 21, 1998, the Food & Drug Administration issued a public health advisory warning that caution needed to be used when vacuum extractors were employed in deliveries. The FDA had received reports of 12 deaths and 9 serious injuries. A September 1998 Committee Opinion of the American College of Obstetrics and Gynecology recognizes that the deaths and injuries reported to the FDA may actually be under-reported. ACOG Committee Opinion No. 208, Sept. 1998. Some studies ". . . have found a strong (almost exclusive) association between delivery by vacuum extraction and SGH [subgaleal hematoma–bleeding in the brain]." Journal of Pediatric Child Health, 1996 32, 228-232, p. 231.

Injuries associated with vacuum extraction can be life-threatening. The injuries may leave a child catastrophically brain-injured. The law in Minnesota and in most jurisdictions requires physicians to warn patients of the risks of a particular type of treatment. Whether physicians are fulfilling that obligation when vacuum extractors are used, is less than clear.

Vacuum extractors are used increasingly to assist in deliveries in modern obstetric practices. Along with that increased usage is an increased concern about injury or death to children from use of that device. The hazard may be under-reported. Our office is receiving an increasing number of calls from parents of children believed to have been injured or killed by vacuum extractor usage.

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Terry Wade

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