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When a valid indication for vacuum-assisted birth exists, the relevant obstetric variables should be identified and carefully assessed to determine whether vacuum-assisted birth is appropriate and safe under the clinical circumstances and for the level of experience of the operator. This important decision-making process is considered in Chapters 2 and 3 of the book. This chapter focuses on a few selected technical matters that should, if followed, improve the efficacy and reduce the risk of vacuum-assisted birth.
Assisted vaginal birth (AVB) remains a key aspect of respectful, effective care for women in labour. In trained hands, it is associated with better maternal and neonatal outcomes than the alternative of a caesarean section in late labour. Written to accompany the RCOG Assisted Birth Simulation Training (ROBuST) course, this book provides guidance on the only RCOG-approved, evidence-based techniques for when and how to perform AVB and complex caesarean sections. There are clear descriptions of techniques, plus photographs, diagrams and videos to improve learning. Internationally recognised contributors discuss all aspects of assisted birth, including vacuum and forceps-assisted birth; caesarean section at full dilatation; safe and effective practice of Kielland's forceps; and essential non-technical skills. This second edition includes chapters on providing care within the medico-legal context of modern obstetric practice and on exploring the worldwide trends in AVB. This remains a much-valued, and much-consulted, part of any accoucheur's library.
Nowadays, concerns regarding operative vaginal birth (OVB) that need to be addressed at a national and institutional level in many countries. This chapter presents general notes on vacuum extraction and forceps to assist vaginal birth. The varying circumstances of practice between countries and hospitals within countries mean that, unless a trainee has opportunities to be trained in a variety of hospitals and regions, it is unlikely that the goals of the RCOG Green-top Guideline on operative vaginal delivery will be attained. One of the purposes of this book, and the ROBuST training course that accompanies it, is to ensure that trainees have the opportunity to develop skills in both methods of OVB. In the developing countries where operative obstetric skills have been maintained, OVB is carried out when there are concerns in terms of 'fit'. Skills training workshops in emergency and newborn care are many and varied too.
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