title: [Frequency and indication for vacuum extractor delivery].
abstract: The aim of the study is to analyze the frequency of the vacuum extraction delivery (VE) and the contemporary indications for its use and their frequency. The study included 44,109 births occurred for 14 years period. This clinical trial is prospective and retrospective on 1197 applied VE. The extraction of the fetus was performed by soft cup silicone vacuum extractor type Ameda - Egnell and electric vacuum pump Atmos. We find 4 main indications for VE: acute fetal distress, labor dystokia, arrest of descent and need to avoid voluntary maternal expulsive efforts.
  
  
  RESULTS
  The frequency of the VE in the 14 years period was 2.71% with an increasing temps from 2% in the beginning of the period and 5% by its end. The most common indication for VE in 37.08% is acute fetal distress followed by the labor dystokia in 31.42% of the cases. The arrest of descent of the fetal head is indication in 25.31% of the applied VE. The need to avoid voluntary maternal expulsive efforts was indication for VE in 5.48% of the cases. The vacuum stimulation was an indication only in 0.71% of the cases.
  
  
  CONCLUSIONS
  VE is a useful method nowadays in assisted vaginal delivery. VE should not be used in breech presentation. The contemporary indications for VE are: maternal indications (labor dystokia and need to avoid voluntary maternal expulsive efforts) and fetal indications (acute fetal distress and arrest of descent). The acute fetal distress is the leading indication, but with tendency of equalization/decreasing compared to labor dystokia and the arrest of descent. Vacuum stimulation is no more an indication for VE.
authors.forename: A
authors.initials: A
authors.lastname: Nikolov
authors.forename: C
authors.initials: C
authors.lastname: Nashar
authors.forename: E
authors.initials: E
authors.lastname: Pavlova
authors.forename: A
authors.initials: A
authors.lastname: Dimitrov
mesh_terms: D000293:Adolescent; D000328:Adult; D002031:Bulgaria / Q000453:epidemiology; D005260:Female; D005316:Fetal Distress / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000517:prevention & control; D011247:Pregnancy; D011446:Prospective Studies; D012189:Retrospective Studies; D014620:Vacuum Extraction, Obstetrical / Q000639:trends; D055815:Young Adult