From the Research
Vacuum-assisted delivery is generally not recommended for premature infants born before 34 weeks of gestation, and the safest approach is to use vacuum assistance only for deliveries at or beyond 34 weeks gestation. This restriction exists because premature infants, especially those under 34 weeks, have fragile skulls with incomplete ossification and are at significantly higher risk for intracranial hemorrhage and other birth injuries when vacuum extraction is applied 1. The soft, pliable nature of the premature infant's skull makes it susceptible to excessive molding, chignon formation (artificial caput), and potential damage to underlying brain tissue when negative pressure is applied.
Some key points to consider when evaluating the use of vacuum-assisted delivery in premature infants include:
- The risk of intracranial hemorrhage and other birth injuries is higher in premature infants, especially those under 34 weeks 2
- Forceps may be considered as an alternative instrumental delivery method for deliveries before 34 weeks, though each case requires careful evaluation of risks and benefits
- The decision to perform any assisted vaginal delivery in premature infants should involve thorough assessment of maternal and fetal factors, with cesarean delivery often being the safer option for very premature infants requiring expedited delivery
- Advanced maternal age is not a significant factor in vacuum-assisted delivery outcomes, according to a recent study 3
It's essential to prioritize the safety and well-being of both the mother and the infant when making decisions about vacuum-assisted delivery, and to carefully weigh the potential risks and benefits of this procedure in the context of premature birth.