A great advantage of a vacuum extraction is that local infiltration of the perineum with 1% lignocaine is the only analgesia required.
The cup is:
Care is taken not include any vaginal or cervical tissue in the vacuum cup.
A negative pressure of 0.8 kg/square cm is applied over 4 minutes. This allows the formation of the chignon, allowing maximum contact of the cup with the scalp.
Traction is applied:
If there is no obvious descent after 4 contractions then a caesarian section should be performed.
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