In a message dated 5/15/2006 1:48:41 PM Eastern Daylight Time,
[log in to unmask] writes:
Having worked in a labor and delivery as an RN for 10 years it was always my
understanding that this procedure was indicated to potentially save the life
of a baby, or prevent brain damage in a baby who is experiencing fetal
distress.
Dear Friends:
A main reason to use a vacuum is to get the baby out because the mother
is not able to push and/or the baby is in an unfavorable position for
delivery; both these conditions can be side effects of epidural anesthesia.
(Obstructed labor is one of the top 3 global reasons for maternal death
in labor. Our propensity to make big heads along with our bipedal stance is
another factor contributing to an obstructed labor.) As we have an element in
our basic physiology that can result in obstructed labor, it doesn't make
sense to add some medication or procedure to potentiate that factor, does it?
In May 1998, the FDA issued an advisory against the use of vacuum
extractions. _http://www.fda.gov/cdrh/fetal598.html_
(http://www.fda.gov/cdrh/fetal598.html)
In part, this advisory says:
PURPOSE
This is to advise you that vacuum assisted delivery devices may cause serious
or fatal complications, and to provide guidance to minimize the risk. While
no instrumented delivery is risk free, we are concerned that some health care
professionals who use vacuum assisted delivery devices, or those who care
for these infants following delivery, may not be aware that the device may
produce life-threatening complications (see attached list for sample of
references). We are also concerned that if health care professionals responsible for
the care of neonates are not alerted when a vacuum assisted delivery device
has been used on a particular infant, they may not adequately monitor for the
signs and symptoms of device-related injuries.
BACKGROUND
Over the past four years, FDA has received reports of 12 deaths and nine
serious injuries among newborns on whom vacuum assisted delivery devices were
used, an average of five events per year. In contrast, during the preceding 11
years there were four deaths and five serious injuries reported to us, fewer
than one event per year. Part, but probably not all, of this five-fold
increase can be explained by an increase in usage – based upon data from 1989-1995,
it is estimated that use of vacuum assisted delivery devices increased from
3.5 percent of all deliveries to 5.9 percent.
-------------------------------------------------------------------------
Clinically, babies with the cephalhematomas from vacuum are very sluggish to
go to breast. They have headaches, at the very least. This bruising
contributes to a higher bilirubin level, which can lead to more testing, separation
from mother, and supplementation with bottles, all of which are risk factors
for breastfeeding
warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Maternal-Child Adjunct Faculty Union Institute and University
Film Reviews Editor, Journal of Human Lactation
www.breastfeedingalwaysbest.com
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