title: Stepwise compared with rapid application of vacuum in ventouse extraction procedures.
abstract: OBJECTIVE
  To compare a one-step (rapid) application of negative pressure (vacuum) with conventional stepwise application for ventouse extraction following a prolonged second stage of labour.
  
  
  METHODS
  Randomised controlled study.
  
  
  METHODS
  Teaching Hospital.
  
  
  METHODS
  Forty-seven women were randomised to the rapid vacuum group and 47 to the stepwise group.
  
  
  METHODS
  Duration of ventouse procedure, effectiveness of methods of application, morbidity of mother and infant.
  
  
  RESULTS
  There was no significant difference in frequency of detachment of the cup after rapid or stepwise application of vacuum. A reduction in mean duration of the ventouse procedure of 6 min was realised without significant difference in maternal or neonatal morbidity.
  
  
  CONCLUSIONS
  Rapid application of vacuum significantly reduces the duration of a ventouse extraction procedure without compromise to efficiency and safety.
authors.affiliation: Department of Obstetrics and Gynaecology, Leyenburg Teaching Hospital, The Hague, The Netherlands.
authors.forename: F T
authors.initials: FT
authors.lastname: Lim
authors.forename: J P
authors.initials: JP
authors.lastname: Holm
authors.forename: N W
authors.initials: NW
authors.lastname: Schuitemaker
authors.forename: F H
authors.initials: FH
authors.lastname: Jansen
authors.forename: J
authors.initials: J
authors.lastname: Hermans
mesh_terms: D000136:Acid-Base Equilibrium; D001034:Apgar Score; D005260:Female; D005312:Fetal Blood; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D018730:Infant Behavior; D007231:Infant, Newborn; D007748:Labor Stage, Second; D007744:Obstetric Labor Complications / Q000628:therapy*; D011247:Pregnancy; D011312:Pressure; D012535:Scalp / Q000293:injuries; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects / Q000379:methods*