Vacuum Extraction and Symphysiotomy in Difficult Vaginal Delivery in a Developing Community

Abstract

A method of dealing with the problem of assisted vaginal delivery in a developing country is presented. An attempt is made to evaluate the place of the vacuum extractor, either alone or with symphysiotomy, against a background which no longer exists in more advanced and more sophisticated communities. The dangers to the mother and child of the more traditional methods of operative delivery, caesarean section and forceps, are shown. By the use of the present method forceps delivery may be eliminated altogether if desired, and sometimes caesarean section may be prevented. It is now widely appreciated that symphysiotomy has a definite place in obstetric practice in Africa, but it is thought that the addition of the vacuum extractor is an advance and a refinement which simplifies the whole problem of difficult vaginal delivery. Some of the differences inherent in the use of the vacuum extractor in Africa, compared with its use in other continents, are mentioned, as it is believed that these differences are important and have been arrived at only after many instances of unnecessary scalp injury. It is hoped that the experience gained at Mulago Hospital will encourage the wider use of this method in areas with similar obstetric problems. © 1966, British Medical Journal Publishing Group. All rights reserved.