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Although there is a declined use of instruments during vaginal delivery in modern obstetrics, vacuum device has recently gained popularity over forceps. The need for instrumental delivery is especially important in low income countries, where the necessary expertise is not always available for caesarean section. Vacuum device should only be used when indicated, commonly for prolonged 2nd stage and non reassuring fetal heart. In addition, operator experience is of utmost importance.
The vacuum is a safe and effective device for instrumental vaginal delivery, associated with less maternal injury, lesser analgesia and need of less expertise. This article reviews in detail the indications, contraindications, patient selection and procedure for vacuum-assisted vaginal delivery. It is always important that a clinician is well versed with maternal and fetal risks associated with the device and the alternate options available.