Experiencia de parto instrumental con vacuum en Hospital Público de Santiago de Chile / Experience of vacuum-assisted instrumental delivery in a Public Hospital in Santiago, Chile

Introducción: El vacuum es el instrumento de elección para asistir el parto instrumental en países desarrollados. Objetivo: El objetivo del estudio es exponer los resultados maternos y fetales del uso del vacuum en población chilena y promover su disponibilidad y uso en nuestro país y Latinoamérica. Método: El estudio se realizó entre octubre de 2017 y diciembre de 2021, incluyendo a pacientes que tuvieron parto instrumental con vacuum en el Hospital San Juan de Dios de Chile. Se compararon los partos exitosos con vacuum y los partos en los que se requirió el uso de otro instrumento o una cesárea posterior al uso del instrumento. Resultados: Se realizaron 153 vacuum, correspondientes al 28,59% del total de partos instrumentales. El 79,74% tuvo éxito. El 5,88% no recibió anestesia o se aplicó anestesia local. Solo el 3,27% presentó desgarro perineal con compromiso del esfínter anal. El 91,5% de los recién nacidos no tuvieron complicaciones fetales. Un 20,3% requirió reanimación neonatal. Conclusiones: El estudio muestra que el vacuum es una opción segura y efectiva de parto instrumental en nuestra población. La correcta capacitación y protocolos adecuados son necesarios para garantizar resultados exitosos.

Introduction: Vacuum extraction is the instrument of choice for assisting instrumental delivery in developed countries. Objective: The aim of the study is to present the maternal and fetal outcomes of vacuum use in the Chilean population and promote its availability and usage in our country and Latin America. Method: The study was performed between October 2017 and December 2021, including patients who underwent instrumental delivery with a vacuum extraction at the Hospital San Juan de Dios in Chile. Successful vacuum deliveries were compared with deliveries where another instrument was required, or a cesarean section was performed after instrument use. Results: A total of 153 vacuum deliveries were carried out, accounting for 28.59% of all instrumental deliveries. 79.74% were successful. 5.88% did not receive anesthesia or received local anesthesia. Only 3.27% experienced perineal tear with involvement of the anal sphincter. 91.5% of newborns had no fetal complications. 20.3% required neonatal resuscitation. Conclusions: The study demonstrates that the vacuum is a safe and effective option for instrumental delivery in our population. Proper training and appropriate protocols are necessary to ensure successful outcomes.

Simplifying the use of the Kiwi vacuum.

A simplified and easily teachable method of performing Kiwi vacuums is described. The Kiwi Omnicup has several features which make it the ideal instrument for correcting malposition. Once the correct position of the fetus is ascertained using ultrasound, it is always possible to maneuver the cup over the flexion point. A retrospective study was undertaken of 239 consecutive patients in the author's private practice requiring assisted delivery from 2010 until 2016. No case was declined. Successful Kiwi vacuum delivery was achieved in 233 cases (98%) and complication rates were low.

Ventosa obstétrica / Vacuum extractor

La ventosa obstétrica es un instrumento que se basa en la aplicación de una cazoleta sobre la presentación fetal, se fija a esta mediante la aplicación de presión negativa y permite realizar tracción sobre ella para favorecer los mecanismos del parto. En este artículo se repasan las características técnicas de este instrumento, su técnica de aplicación y las complicaciones neonatales asociadas a su uso

Obstetric vacuum extraction is based on the application of a cup to the fetal head which is fixed by negative pressure allowing us to make traction to the fetal presentation favouring delivery mechanisms. In this article we review the technical characteristics of this instrument, technics of application and neonatal complications associated with its use